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Study Design of the Graft Patency After FFR-Guided Versus Angiography-Guided CABG Trial (GRAFFITI)

2018Journal article Open access
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dc.contributor.authorToth, GG
dc.contributor.authorDe Bruyne, B
dc.contributor.authorKala, P
dc.contributor.authorRibichini, FL
dc.contributor.authorCasselman, F
dc.contributor.authorRamos, R
dc.contributor.authorPiroth, Z
dc.contributor.authorFournier, S
dc.contributor.authorVan Mieghem, C
dc.contributor.authorPenicka, M
dc.contributor.authorMates, M
dc.contributor.authorVan Praet, F
dc.contributor.authorDegriek, I
dc.contributor.authorBarbato, E
dc.date.accessioned2019-11-12T15:50:02Z
dc.date.available2019-11-12T15:50:02Z
dc.date.issued2018
dc.description.abstractClinical benefit of invasive functionally guided revascularization has been mostly investigated and proven for percutaneous coronary intervention. It has never been prospectively evaluated whether a systematic fractional flow reserve (FFR) assessment is also beneficial in guiding coronary artery bypass graft surgery (CABG). The objective of the GRAft patency after FFR-guided versus angiography-guIded CABG (GRAFFITI) trial was to compare an FFR-guided revascularization strategy to the traditional angiography-guided revascularization strategy for patients undergoing CABG. Patients were enrolled with significantly diseased left anterior descending or left main stem and at least one major coronary artery with angiographically intermediate stenosis (30-90% diameter stenosis) that was assessed by FFR. Thereafter, while the FFR values were kept concealed, cardiac surgeons decided their intended procedural strategy based on the coronary angiography alone. At this point, patients underwent 1:1 randomization to either an FFR-guided or an angiography-guided CABG strategy. In case the patient was randomized to angiography-guided arm, cardiac surgeons kept their intended procedural strategy, i.e., CABG was guided solely on the basis of the coronary angiography. In case the patient was randomized to the FFR-guided arm, FFR values were disclosed to the surgeons who revised the surgical protocol according to the functional significance of each coronary stenosis. The primary endpoint of the trial was the rate of graft occlusion at 12 months, assessed by coronary computed tomography or coronary angiography. The secondary endpoints were (1) length of postoperative hospital stay; (2) changes in surgical strategy depending upon FFR results (in FFR-guided group only); and (3) rate of major adverse cardiac and cerebrovascular events, i.e., composite of death, myocardial infarction, stroke, and any revascularization during the follow-up period. This study is the first prospective randomized trial investigating potential clinical benefits, associated with FFR-guided surgical revascularization.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Cardiovasc Transl Res. 2018 Aug;11(4):269-273.pt_PT
dc.identifier.doi10.1007/s12265-018-9818-9pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3355
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringerpt_PT
dc.subjectCoronary Angiographypt_PT
dc.subjectCoronary Artery Bypasspt_PT
dc.subjectCoronary Artery Diseasept_PT
dc.subjectCoronary Vesselspt_PT
dc.subjectFemalept_PT
dc.subjectFollow-Up Studiespt_PT
dc.subjectFractional Flow Reserve, Myocardialpt_PT
dc.subjectHumanspt_PT
dc.subjectMalept_PT
dc.subjectProspective Studiespt_PT
dc.subjectSingle-Blind Methodpt_PT
dc.subjectSurgery, Computer-Assistedpt_PT
dc.subjectTreatment Outcomept_PT
dc.subjectBlood Vessel Prosthesispt_PT
dc.subjectVascular Patencypt_PT
dc.subjectHSM CARpt_PT
dc.titleStudy Design of the Graft Patency After FFR-Guided Versus Angiography-Guided CABG Trial (GRAFFITI)pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage273pt_PT
oaire.citation.issue4pt_PT
oaire.citation.startPage269pt_PT
oaire.citation.titleJournal of Cardiovascular Translational Researchpt_PT
oaire.citation.volume11pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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