1 resultado para lean strategy selection, leanness assessment, optimisation
em Hospital Prof. Dr. Fernando Fonseca - Portugal
Filtro por publicador
- JISC Information Environment Repository (1)
- Repository Napier (2)
- Aberystwyth University Repository - Reino Unido (4)
- Academic Archive On-line (Jönköping University; Sweden) (3)
- Acceda, el repositorio institucional de la Universidad de Las Palmas de Gran Canaria. España (1)
- AMS Tesi di Dottorato - Alm@DL - Università di Bologna (7)
- AMS Tesi di Laurea - Alm@DL - Università di Bologna (1)
- Aquatic Commons (18)
- ArchiMeD - Elektronische Publikationen der Universität Mainz - Alemanha (1)
- Archimer: Archive de l'Institut francais de recherche pour l'exploitation de la mer (3)
- Archive of European Integration (17)
- Archivo Digital para la Docencia y la Investigación - Repositorio Institucional de la Universidad del País Vasco (5)
- Aston University Research Archive (57)
- Avian Conservation and Ecology - Eletronic Cientific Hournal - Écologie et conservation des oiseaux: (4)
- Biblioteca de Teses e Dissertações da USP (1)
- Biblioteca Digital | Sistema Integrado de Documentación | UNCuyo - UNCUYO. UNIVERSIDAD NACIONAL DE CUYO. (2)
- Biblioteca Digital da Produção Intelectual da Universidade de São Paulo (12)
- Biblioteca Digital da Produção Intelectual da Universidade de São Paulo (BDPI/USP) (3)
- Biblioteca Digital de Teses e Dissertações Eletrônicas da UERJ (1)
- BORIS: Bern Open Repository and Information System - Berna - Suiça (34)
- Boston University Digital Common (1)
- Brock University, Canada (4)
- Bulgarian Digital Mathematics Library at IMI-BAS (2)
- Cambridge University Engineering Department Publications Database (19)
- CentAUR: Central Archive University of Reading - UK (32)
- Chinese Academy of Sciences Institutional Repositories Grid Portal (3)
- Cochin University of Science & Technology (CUSAT), India (2)
- Coffee Science - Universidade Federal de Lavras (2)
- Collection Of Biostatistics Research Archive (1)
- Comissão Econômica para a América Latina e o Caribe (CEPAL) (13)
- CORA - Cork Open Research Archive - University College Cork - Ireland (7)
- Corvinus Research Archive - The institutional repository for the Corvinus University of Budapest (16)
- CUNY Academic Works (1)
- Dalarna University College Electronic Archive (3)
- Deakin Research Online - Australia (80)
- Department of Computer Science E-Repository - King's College London, Strand, London (1)
- Digital Commons - Michigan Tech (1)
- Digital Commons - Montana Tech (2)
- Digital Commons @ DU | University of Denver Research (1)
- Digital Commons at Florida International University (12)
- Digital Repository at Iowa State University (1)
- DigitalCommons@The Texas Medical Center (6)
- DigitalCommons@University of Nebraska - Lincoln (1)
- Doria (National Library of Finland DSpace Services) - National Library of Finland, Finland (4)
- Duke University (1)
- eResearch Archive - Queensland Department of Agriculture; Fisheries and Forestry (18)
- FUNDAJ - Fundação Joaquim Nabuco (4)
- Glasgow Theses Service (2)
- Greenwich Academic Literature Archive - UK (10)
- Helda - Digital Repository of University of Helsinki (3)
- Hospital Prof. Dr. Fernando Fonseca - Portugal (1)
- Indian Institute of Science - Bangalore - Índia (17)
- Instituto Gulbenkian de Ciência (1)
- Instituto Nacional de Saúde de Portugal (1)
- Instituto Politécnico do Porto, Portugal (6)
- Iowa Publications Online (IPO) - State Library, State of Iowa (Iowa), United States (3)
- Laboratório Nacional de Energia e Geologia - Portugal (1)
- Massachusetts Institute of Technology (4)
- National Center for Biotechnology Information - NCBI (10)
- Nottingham eTheses (6)
- Plymouth Marine Science Electronic Archive (PlyMSEA) (13)
- Portal de Revistas Científicas Complutenses - Espanha (4)
- QSpace: Queen's University - Canada (4)
- QUB Research Portal - Research Directory and Institutional Repository for Queen's University Belfast (56)
- Queensland University of Technology - ePrints Archive (106)
- RCAAP - Repositório Científico de Acesso Aberto de Portugal (1)
- RDBU - Repositório Digital da Biblioteca da Unisinos (2)
- Repositorio Académico de la Universidad Nacional de Costa Rica (2)
- Repositório Alice (Acesso Livre à Informação Científica da Embrapa / Repository Open Access to Scientific Information from Embrapa) (2)
- Repositório Científico da Universidade de Évora - Portugal (3)
- Repositório Científico do Instituto Politécnico de Lisboa - Portugal (5)
- Repositório digital da Fundação Getúlio Vargas - FGV (8)
- Repositório Digital da UNIVERSIDADE DA MADEIRA - Portugal (1)
- Repositório do Centro Hospitalar de Lisboa Central, EPE - Centro Hospitalar de Lisboa Central, EPE, Portugal (1)
- Repositório Institucional da Universidade de Aveiro - Portugal (5)
- Repositório Institucional UNESP - Universidade Estadual Paulista "Julio de Mesquita Filho" (33)
- Repositorio Institucional Universidad de Medellín (1)
- RUN (Repositório da Universidade Nova de Lisboa) - FCT (Faculdade de Cienecias e Technologia), Universidade Nova de Lisboa (UNL), Portugal (11)
- SAPIENTIA - Universidade do Algarve - Portugal (2)
- School of Medicine, Washington University, United States (1)
- Universidad de Alicante (5)
- Universidad del Rosario, Colombia (18)
- Universidad Politécnica de Madrid (15)
- Universidade Complutense de Madrid (1)
- Universidade de Lisboa - Repositório Aberto (2)
- Universidade Federal do Rio Grande do Norte (UFRN) (1)
- Universitat de Girona, Spain (3)
- Universitätsbibliothek Kassel, Universität Kassel, Germany (4)
- Université de Lausanne, Switzerland (6)
- Université de Montréal (2)
- Université de Montréal, Canada (11)
- Université Laval Mémoires et thèses électroniques (1)
- University of Michigan (11)
- University of Queensland eSpace - Australia (28)
- University of Washington (6)
- WestminsterResearch - UK (5)
Resumo:
Penetration of fractional flow reserve (FFR) in clinical practice varies extensively, and the applicability of results from randomized trials is understudied. We describe the extent to which the information gained from routine FFR affects patient management strategy and clinical outcome. METHODS AND RESULTS: Nonselected patients undergoing coronary angiography, in which at least 1 lesion was interrogated by FFR, were prospectively enrolled in a multicenter registry. FFR-driven change in management strategy (medical therapy, revascularization, or additional stress imaging) was assessed per-lesion and per-patient, and the agreement between final and initial strategies was recorded. Cardiovascular death, myocardial infarction, or unplanned revascularization (MACE) at 1 year was recorded. A total of 1293 lesions were evaluated in 918 patients (mean FFR, 0.81±0.1). Management plan changed in 406 patients (44.2%) and 584 lesions (45.2%). One-year MACE was 6.9%; patients in whom all lesions were deferred had a lower MACE rate (5.3%) than those with at least 1 lesion revascularized (7.3%) or left untreated despite FFR≤0.80 (13.6%; log-rank P=0.014). At the lesion level, deferral of those with an FFR≤0.80 was associated with a 3.1-fold increase in the hazard of cardiovascular death/myocardial infarction/target lesion revascularization (P=0.012). Independent predictors of target lesion revascularization in the deferred lesions were proximal location of the lesion, B2/C type and FFR. CONCLUSIONS: Routine FFR assessment of coronary lesions safely changes management strategy in almost half of the cases. Also, it accurately identifies patients and lesions with a low likelihood of events, in which revascularization can be safely deferred, as opposed to those at high risk when ischemic lesions are left untreated, thus confirming results from randomized trials.