{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T15:44:58Z","timestamp":1768923898833,"version":"3.49.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,8,2]]},"abstract":"\n Background<\/jats:title>\n \n Data are limited regarding outcomes of deferred lesions in patients with angiographically insignificant stenosis but low fractional flow reserve (\n FFR<\/jats:styled-content>\n ). We investigated the natural history of angiographically insignificant stenosis with low\n FFR<\/jats:styled-content>\n among patients who underwent routine 3\u2010vessel\n FFR<\/jats:styled-content>\n measurement.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n From December 2011 to March 2014, 1136 patients with 3298 vessels underwent routine 3\u2010vessel\n FFR<\/jats:styled-content>\n measurement (3V\n FFR<\/jats:styled-content>\n \u2010\n FRIENDS<\/jats:styled-content>\n study,\n ClinicalTrials.gov<\/jats:ext-link>\n identifier\n NCT<\/jats:styled-content>\n 01621438), and this study analyzed the 2\u2010year clinical outcomes of 1024 patients with 2124 lesions with angiographically insignificant stenosis (percentage of diameter stenosis <50%), in which revascularization was deferred. All lesions were classified according to\n FFR<\/jats:styled-content>\n values, using a cutoff of 0.80 (high\n FFR<\/jats:styled-content>\n >0.80 versus low\n FFR<\/jats:styled-content>\n \u22640.80). The primary end point was outcome of major adverse cardiovascular events (a composite of cardiac death, myocardial infarction, and ischemia\u2010driven revascularization) at 2\u00a0years. Mean angiographic percentage of diameter stenosis and\n FFR<\/jats:styled-content>\n of total lesions were 32.5\u00b110.3% and 0.91\u00b10.08%, respectively. Among the total lesions with angiographically insignificant stenosis, 8.7% showed low\n FFR<\/jats:styled-content>\n (185 lesions). The incidence of lesions with low\n FFR<\/jats:styled-content>\n was 2.5%, 3.8%, 9.0%, and 15.1% in categories of percentage of diameter stenosis <20%, 20% to 30%, 30% to 40%, and 40% to 50%, respectively. At 2\u2010year follow\u2010up, the low\u2010\n FFR<\/jats:styled-content>\n group showed a significantly higher risk of major adverse cardiovascular events compared with the high\n FFR<\/jats:styled-content>\n group (3.3% versus 1.2%, hazard ratio: 3.371; 95%\n CI,<\/jats:styled-content>\n 1.346\u20138.442;\n P<\/jats:italic>\n =0.009). In multivariable analysis, low\n FFR<\/jats:styled-content>\n was the most powerful independent predictor of future\n MACE<\/jats:styled-content>\n in deferred lesions with angiographically insignificant stenosis (adjusted hazard ratio: 2.617; 95%\n CI<\/jats:styled-content>\n , 1.026\u20136.679;\n P<\/jats:italic>\n =0.044).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In deferred angiographically insignificant stenosis, lesions with low\n FFR<\/jats:styled-content>\n showed significantly higher event rates than those with high\n FFR<\/jats:styled-content>\n .\n FFR<\/jats:styled-content>\n was an independent predictor of future major adverse cardiovascular events in lesions with angiographically insignificant stenosis.\n <\/jats:p>\n <\/jats:sec>\n \n Clinical Trial Registration<\/jats:title>\n \n URL<\/jats:styled-content>\n :\n http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n . Unique identifier:\n NCT<\/jats:styled-content>\n 01621438.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.117.006071","type":"journal-article","created":{"date-parts":[[2017,9,1]],"date-time":"2017-09-01T18:25:38Z","timestamp":1504290338000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Clinical Outcomes of Deferred Lesions With Angiographically Insignificant Stenosis But Low Fractional Flow Reserve"],"prefix":"10.1161","volume":"6","author":[{"given":"Joo Myung","family":"Lee","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bon\u2010Kwon","family":"Koo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea"},{"name":"Institute on Aging, Seoul National University, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eun\u2010Seok","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang\u2010Wook","family":"Nam","sequence":"additional","affiliation":[{"name":"Department of Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joon\u2010Hyung","family":"Doh","sequence":"additional","affiliation":[{"name":"Department of Medicine, Inje University Ilsan Paik Hospital, Goyang, South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinyang","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fei","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaoliang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junqing","family":"Yang","sequence":"additional","affiliation":[{"name":"Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiyan","family":"Chen","sequence":"additional","affiliation":[{"name":"Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuhiro","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tokyo Medical University, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyoshi","family":"Yokoi","sequence":"additional","affiliation":[{"name":"Kokura Memorial Hospital, Kitakyuku, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hitoshi","family":"Matsuo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Gifu Heart Center, Gifu, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Takashima","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aichi Medical University, Nagakute, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasutsugu","family":"Shiono","sequence":"additional","affiliation":[{"name":"Wakayama Medical University, Wakayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doyeon","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonghanne","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyung\u2010Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Akasaka","sequence":"additional","affiliation":[{"name":"Wakayama Medical University, Wakayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, 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