Impact of Proton Pump Inhibitors on Efficacy of Antiplatelet Strategies With Ticagrelor or Aspirin After Percutaneous Coronary Intervention

Abstract

BACKGROUND A new method based on the principle of thermodilu-tion has been validated to quantify volumetric coronary absolute flow. This technique requires an intracoronary infusion of saline solution at room temperature through a dedicated catheter that induces steady-state maximal hyperemia at a flow rate 20 mL/min. Our aim was to compare fractional flow reserve (FFR) using intracoronary saline infusion (FFRsaline) versus conventional FFR with adenosine (FFRadenosine) METHODS In 118 patients with suspected coronary disease in 3 centers , FFRsaline and FFRadenosine were measured. Adenosine endo-venous infusion was set at a mean rate of 165 mg/kg/min (range 150-180) RESULTS The mean value of FFRsaline was 0.89 AE 0.07 and of FFRadenosine 0.90 AE 0.05; and the mean difference between both methods was 0.03 AE 0.03, which can be attributed to the ray-flow catheter effect on the coronary flow. Both parameters showed good correlation (r ¼ 0.73; P < 0.01). FFRadenosine and FFRsaline were dichotomized (cutoff value 0.8) and FFRadenosine and FFRsaline were concordant in 93.3% of cases. Using the cutoff value of 0.75 the concordance was higher (98.5% of cases). Considering coronary vessel without coronary disease according to FFRadenosine, the concordance between both parameters was 99%. CONCLUSION FFRsaline and FFRadenosine showed good correlation. The concordance between both parameters showed a tendency to be higher in nondiseased vessels, suggesting that FFRsaline could be a useful adenosine-free index to defer coronary lesions. CATEGORIES IMAGING AND PHYSIOLOGY: Physiologic Lesion Assessment BACKGROUND Drug-eluting balloons (DEBs) are a feasible method of rapid delivery of drug to the vessel wall during a single balloon inflation without the need to leave a permanent implant. Their efficacy has been established for in-stent restenosis and small vessels but there are limited data for their use in bifurcation lesions.