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Evaluation of new criteria for diagnosis of diabetes mellitus based on follow-up study of borderline diabetes.

In order to evaluate the validity of recently proposed criteria for diagnosis of diabetes mellitus, a retrospective study was performed in 315 patients with borderline diabetes, who were selected from approximately 4,000 outpatients under treatment for more than three years. They were divided into two groups, BI and BII, according to the 2-hr blood glucose level in the 50 g glucose tolerance test (GTT): BI between 100 and 135 mg/100 ml and BII between 135 and 195 mg/100 ml. In group BI, glucose tolerance was deteriorated in 38 of 75 patients (51%) and converted to diabetes mellitus in 21 patients (28%). In group BII, 78 among 232 patients (34%) developed diabetes mellitus. Furthermore, in 85% of the 99 cases of the conversion to diabetes mellitus from borderline diabetes, it occurred within 5 years. Diabetic retinopathy was observed in 25 of 72 patients (35%) in group BI and in 60 of 212 patients (28%) in group BII. More than two thirds of the patients with diabetic retinopathy observed in the borderline diabetes developed their retinopathy within 5 years. Normal insulin response during GTT was proved only in 21% and 17% among groups BI and BII, respectively. These results indicate that the patients with borderline diabetes BI as well as BII, are closely related with diabetes mellitus, and that the patients with impaired glucose tolerance should be treated with diet restriction as in diabetes mellitus.

Adult↗

Effect of dietary potassium chloride in borderline hypertensive rats.

The borderline hypertensive rat is the first filial offspring of the spontaneously hypertensive rat and the Wistar-Kyoto rat. With increased dietary sodium chloride intake, the borderline hypertensive rat develops hypertension and exaggerated cardiovascular and renal responses to acute environmental stress, similar to those observed in the hypertensive spontaneously hypertensive rat parent. In other models of sodium chloride-sensitive hypertension with different genetic background (Dahl rat), dietary potassium chloride supplementation protects against the development of hypertension, increased sympathetic nervous system activity, and exaggerated responses to acute environmental stress. This investigation sought to determine whether the dietary sodium chloride-induced development of both the hypertension and the exaggerated responses to acute environmental stress could be reversed or prevented by increased dietary potassium chloride intake. Dietary potassium chloride intake was increased with a 1% potassium chloride drinking solution either after 12 wk of 8% sodium chloride intake (reversal) or concomitant with the onset of 12 wk of 8% sodium chloride intake (prevention). An increase in dietary potassium chloride intake did not reverse or prevent the development of either the hypertension or the exaggerated cardiovascular and renal responses to acute environmental stress in borderline hypertensive rats fed 8% sodium chloride. It is concluded that the difference in genetic background between borderline hypertensive rats and other models of sodium chloride-sensitive hypertension is an important determinant of the protective effect of dietary potassium chloride supplementation.

Animals↗

Comparison of diagnostic criteria of IGT, borderline, and GDM. Blood glucose curve and IRI response.

A 75-g oral glucose tolerance test (OGTT) was performed in 615 nonobese pregnant women (mean +/- SD age 29.7 +/- 4.3 yr) who were referred to the Division of Internal Medicine at our diabetes center because of glycosuria. Seventy-seven cases were found to have urinary glucose at the first trimester, 185 at the second trimester, and 353 at the third trimester. With their 75-g OGTT results, the diagnostic criteria of borderline (formulated by the Japan Diabetes Society), impaired glucose tolerance (IGT; defined by the World Health Organization [WHO]), and gestational diabetes mellitus (GDM; determined by the Japan Society of Obstetrics & Gynecology standards) were compared through blood glucose (BG) curves and immunoreactive insulin (IRI) responses. Borderline (fasting BG greater than or equal to 6.1 and less than 7.8 mM and 2-h BG greater than or equal to 6.7 and less than 11.1 mM) is neither diabetes nor normal. IGT is as referred to by the WHO. GDM exceeds two points of fasting BG greater than or equal to 5.6 mM, 1-h BG greater than or equal to 10.0 mM, or 2-h BG greater than or equal to 8.3 mM. Diabetes mellitus (DM) is as referred to by the Japan Diabetes Society (same as the WHO). The prevalence of abnormal glucose tolerance among all 615 pregnant women was 54.6% in borderline, 24.5% in IGT, 7.3% in GDM, and 3.4% in DM. The 2-h BG levels in IGT during the first trimester were higher than in borderline (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Borderline sweat test: criteria for cystic fibrosis diagnosis.

The CF diagnosis can be difficult in subjects with disease consistent symptoms and borderline values of the sweat test. This study aimed to evaluate possibly resolutory criteria. Seventy-one ill subjects with borderline sweat test values (40-70 mEq/l Cl-) aged 0.1-37.7 years (mean, 8.7; SD, 7.3) were studied and compared with 33 age-matched CF patients (Cl- over 75 mEq/l) and 25 healthy subjects. A complex CF score based on 25 variables was set: CF-specific clinical conditions, detailed analysis of sweat test (salt-free diet test included), pancreatic function, Pseudomonas infection, and others. The score ranged from 0 to a maximum of 65 and clearly distinguished the CF patients from the healthy subjects. Therefore the CF score was assumed as the best reference criterion to define the diagnosis in the borderline group: 27 of them (38%) were assigned to the CF condition and 44 (62%) to the healthy one, with a quite clear separation between the 2 subgroups. With respect to these assignments, the most discriminant variable turned out to be the sweat Cl- persisting above 40 mEq/l after 5 days of salt-free diet (mean error, 18.4%). Neither sweat Cl-/Na+ ratio nor bicarbonate duodenal output showed better discriminant power (mean error, 29% and 25%, respectively). It is concluded that in borderline situations of sweat test results a definite CF diagnosis can be achieved only by compounding many clinical and laboratory data with a preference for the sweat test after a salt-free diet period. The CF score proposal can be an effective help.

Adult↗

Ambulatory monitoring in the evaluation of blood pressure in patients with borderline hypertension and the role of the defense reflex.

The differences between blood pressure (BP) readings taken in the clinic and during normal daily activities were assessed in two studies using a noninvasive ambulatory BP monitor (Avionics). In the first study 30 untreated hypertensive patients (17 with borderline pressures, average diastolic less than or equal to 95, and 13 established hypertensives, diastolics above 95) and 5 normotensive subjects had 30 readings taken in the physician's office and 30 while at home. Conventional sphygmomanometer BPs were also recorded in the office. In the borderline group home BPs were significantly lower than clinic BPs, whereas this difference was less marked for the established and normotensive group. In the second study BP was measured every 15 minutes for 24 hours in 25 normal subjects, 25 borderline and 25 established hypertensives, and readings categorized according to four recording situations: physician's office, work, at home, and sleep. BPs in all groups were highest at work and lowest asleep, and directional changes were similar. Both hypertensive groups showed higher BPs in the physician's office than at home, while normal subjects showed no difference. BPs recorded in the physician's office were good predictors of 24 hour average BP in normal and established hypertensive subjects, but not in the borderline group: in such patients 24 hour monitoring may be of particular value in evaluating the need for treatment.

Adolescent↗

Effects of psychological and physical covariates on plasma catecholamines in borderline hypertensives and offspring of hypertensive parents.

The interpretation of plasma catecholamine measurements may be influenced by psychological and physical factors. Therefore, catecholamine concentrations were adjusted for between-subject differences by the following possible confounding factors, i.e. body-mass index, individual maximal physical work capacity, urinary sodium excretion rates and anxiety score. Subjects were 24 borderline essential hypertensives, aged 18-24 years, 50 age-matched normotensive offspring of hypertensive parents and 49 controls with no family history of hypertension studied at rest and during mental stressors (Stroop colour-word conflict test, mental arithmetic). Borderline hypertensives had consistently higher adjusted venous noradrenaline concentrations than control subjects (p less than 0.05). Adjusted plasma adrenaline concentrations were higher in borderline hypertensive subjects than in offspring of hypertensive parents during supine rest. Despite its limitations, venous plasma noradrenaline concentrations when adjusted for work capacity, body-mass, sodium excretion and anxiety suggest enhanced sympatho-neural activity in young borderline essential hypertensives.

Adolescent↗

The current status of surgical staging of ovarian serous borderline tumors.

BACKGROUND: The purpose of the current study was to evaluate the current practice of surgical staging of ovarian serous borderline tumors. METHODS: Women with a diagnosis of ovarian serous borderline tumors whose pathology slides were sent to the M. D. Anderson Cancer Center for second-opinion diagnostic consultation between 1990-1996 were identified. The original pathology reports and M. D. Anderson Cancer Center consultation reports of 255 cases were reviewed for the frequencies of frozen-section analyses and staging biopsies, biopsy results, the specialty of the surgeon, and hospital type. RESULTS: The majority (78%) of ovarian borderline tumors primarily were encountered and staged by general obstetrician-gynecologists. Overall, 66% of patients had at least 1 staging biopsy performed. Approximately 12% of subjects underwent complete surgical staging, defined as having biopsy samples taken from pelvic and abdominal peritoneum, omentum, and retroperitoneal lymph nodes. Gynecologic oncologists performed complete staging in 50% of cases, obstetrician-gynecologists performed complete staging in 9% of cases, and general surgeons performed complete staging in 0% cases. The overall frequency of a positive staging biopsy was 37%. Approximately 47% (80 of 169) of patients who underwent biopsies were upstaged as a result of positive biopsies, - with 41% (70 of 169) having extrapelvic spread. CONCLUSIONS: Currently, surgical staging for women with ovarian serous borderline tumors remains inadequate, although a significant proportion of patients who undergo staging are noted to have extrapelvic spread.

Adolescent↗

Abnormalities of autonomic nervous control in borderline hypertension.

The systemic hemodynamic was investigated in 145 young male patients with borderline hypertension and 85 control subjects. Response of the cardiac output, stroke volume and the heart rate to sequential parasympathetic, beta-adrenergic and alpha-adrenergic blockade was used for assessment of the autonomic nervous tone. These investigations suggest that the apparently "innocent" minimal blood pressure elevation in borderline hypertension is associated with a number of physiologic abnormalities: The cardiac output, heart rate and stroke volume can be elevated. In all patients the peripheral resistance is abnormal. An abnormal distribution of plasma renin values is detectable. The plasma volume is decreased in a proportion of patients. A number of these abnormalities can be explained by a neurogenic mechanism. The elevation of the cardiac output is entirely neurogenic. In a substantial minority of patients, the elevation of peripheral resistance is attributable to increased sympathetic drive. Indirect evidence indicates that the plasma renin elevation in borderline hypertension may also be neurogenic. Hypothetically the decreased plasma volume may stem from sympathetic effects on postcapillary vessels, but at the present there is no experimental evidence of support this view. The change in autonomic function in borderline hypertension involves both the sympathetic and parasympathetic efferents. Increased sympathetic stimulation is coupled with decrease parasympathetic inhibition. This points toward abnormal integration of the autonomic control, presumably in the medulla oblongata. The mechanism of the autonomic abnormality is not fully elucidated. The role of baroreceptors requires further investigation. In some patients the altered autonomic integration appears to be related to psychosomatic mechanisms.

Adult↗

Recurrent borderline ovarian tumours after conservative management in women wishing to retain their fertility.

OBJECTIVE: To evaluate the rate of recurrence after conservative treatment of Stage 1 borderline ovarian tumors. METHODS: Retrospective case note review of all women with borderline ovarian tumours diagnosed at Aberdeen, U.K. and loannina, Greece between 1981-1993. Outcome measures comprised initial surgery, stage of disease, histological type, pregnancy rate, recurrence rate and disease-free interval. RESULTS: Conservative surgery for borderline tumours in young women permitted high conception rates. Recurrence of tumour was high in this group, 71%, and presented late. CONCLUSION: Prolonged intensive follow-up is required for women treated conservatively for borderline malignant ovarian tumours.

Adult↗

Elevated basal insulin secretion and normal dynamic insulin sensitivity in borderline hypertension.

BACKGROUND AND AIM: Borderline hypertension is often the initial stage of stabilized hypertension. This study aimed to provide insight on insulin behavior and its relationship with glucose metabolism by investigating insulin secretion and hepatic clearance in non-steady-state conditions in borderline hypertensive patients. METHODS AND RESULTS: We studied 15 patients (6 F, 9M, 44 +/- 2 yr, 78 +/- 2 kg, systolic pressure 155 +/- 10 mmHg, diastolic 93 +/- 5) and 15 comparable healthy controls. All underwent an intravenous glucose test, with minimal model analysis to measure insulin sensitivity S1, glucose effectiveness SG, insulin pre-hepatic release, hepatic extraction, and insulin appearance rate in the systemic circulation. Basal glucose (3.98 +/- 0.12 vs 3.94 +/- 0.11 mmol/L, hypertensive vs control subjects respectively), i.v. glucose tolerance factor KG (2.0 +/- 0.2 vs 2.2 +/- 0.1% min-1), SG (0.035 +/- 0.004 vs 0.032 +/- 0.007 min-1) and S1 [3.5 +/- 0.5 vs 3.8 +/- 0.3 10(4) min-1 (microU/mL)] were similar, both basal insulin and C-peptide exhibited a marked increase (87 +/- 8 vs 46 +/- 6 pmol/L, p = 0.0003; 637 +/- 62 vs 381 +/- 76 pmol/L, p < 0.03) demonstrating insulin resistance in basal conditions. Insulin secretion per unit volume was greater in patients, both at basal (43 +/- 5 vs 24 +/- 5 pmol/L/min, p = 0.01) and after stimulation (total hormone released = 18 +/- 2 vs 11 +/- 2 nmol/L in 4 h, p = 0.022). Post-hepatic insulin delivery was also elevated (basal = 11 +/- 1 vs 6 +/- 1 pmol/L/min, p < 0.002, total = 5 +/- 1 vs 3 +/- 0.3 nmol/L in 4 h, p = 0.02), while no difference was detected in hepatic extraction (66 +/- 4% vs 66 +/- 3). CONCLUSION: Borderline hypertensive patients display normal glucose tolerance with basal insulin resistance and normal dynamic insulin sensitivity. Peripheral hyperinsulinemia derives from the combination of normal hepatic extraction with an overproduction of hormone, mostly due to the basal component. Because borderline hypertension often degenerates into overt disease, our results point to a progression that leads to the well-known insulin resistance proper to sustained hypertension.

Adult↗

[Analysis of 196 cases of trial of labor with borderline oligohydramnios assessed by ultrasound].

OBJECTIVE: To determine the effect of borderline oligohydramnios on perinatal outcome. METHOD: Patients admitted for delivery had an amniotic fluid index (AFI) assessment. Color Doppler was used to examine the systolic/diastolic ratio of the blood flow velocity in fetal umbilical arteries. Normal amniotic fluid volume was defined as an AFI of 8.1-18 cm (n = 200), and borderline oligohydramnios as 5.1-8.0 cm (n = 196). The two groups were compared on perinatal outcomes as all of the patients had trial of labor. RESULTS: There was no difference in the incidence of fetal distress and neonatal mortality between the two groups. The incidence of emergency section in borderline oligohydramnios group was significantly higher. CONCLUSION: The patients with borderline oligohydramnios may have a trial of labor under proper intensive care.

Female↗

[Borderline ovarian tumors. Retrospective analysis of 20 cases].

BACKGROUND: To evaluate the clinical features, the surgical management and outcome of 20 patients with stage-I borderline ovarian tumors. METHODS: Twenty cases of FIGO stage-I ovarian tumors, aged from 31 to 58 years (mean 37 years) have been reviewed. All informations of clinical stage, surgical intervention and prognosis were achieved by reviewing hospital records. Minimal requirements for conservative management were adequate staging and complete information about the therapeutic options. Factors important in the choice of the treatment were, age, wish to preserve fertility, histologic type and grade, and the stage of the tumour. RESULTS: Eleven of the 20 patients (55%) were at stage IA, 6 cases (30%) were at stage IB, 3 cases (15%) were at stage IC. Thirteen (65%) were with mucinous cystadenoma of borderline malignancy, 7 cases (35%) were of serous type. Thirteen patients underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH and BSO). Seven patients were treated with unilateral oophorectomy or unilateral salpingo-oophorectomy (USO). One patient underwent enucleation of ovarian tumor and biopsy of contralateral ovary. Any patient were treated with chemotherapy after operation. With a median follow up of two years, we observed no recurrence of carcinoma in women treated conservatively or in those treated more radically. CONCLUSIONS: Conservative surgery remains a therapeutic option in selected patients with borderline ovarian tumors. Prolonged intensive follow-up is required for women treated conservatively for borderline malignant ovarian tumours.

Adult↗

The effect of resistance exercise on recovery blood pressure in normotensive and borderline hypertensive women.

Nine normotensive and 7 borderline hypertensive women were studied to investigate the effects of an acute bout of resistance exercise on recovery blood pressure. The investigation was conducted over 3 sessions. During the first session, subjects were assessed for muscular strength while performing the following exercises: chest press, seated leg press, biceps brachii curl, knee extension, and triceps brachii extension. In a subsequent session, subjects completed 3 circuits of the aforementioned exercises at 50% (15 repetitions) of the estimated 1 repetition maximum (1RM), followed by a 60-minute recovery period. Systolic (SBP) and diastolic (DBP) pressures were assessed via auscultation at 10-minute intervals throughout the recovery period. Subjects were also monitored in a similar manner on a control day in which exercise was excluded. The data were analyzed using a 3-way analysis of variance (ANOVA) with a predetermined alpha level of p < or = 0.05. Women in the borderline hypertensive group exhibited higher SBP (126.5 +/- 3.1 mm Hg) and higher DBP (85.4 +/- 1.8 mm Hg) than their normotensive counterparts (103.5 +/- 2.7 mm Hg; 69.3 +/- 1.6 mm Hg) throughout the study. SBP was significantly lower during recovery from the exercise session (113.8 +/- 2.1 mm Hg) compared with the control session (116.1 +/- 2.1 mm Hg). DBP did not vary between sessions. Although blood pressure was higher in borderline hypertensive subjects, the response of both groups during seated recovery was the same. In conclusion, a single bout of resistance exercise appears to invoke a slight systolic hypotensive response during recovery in normotensive and borderline hypertensive women.

Adult↗

[Pregnancy and delivery after conservative treatment of borderline ovarian tumor with FIGO stage III C--a case report].

This study presents a case of pregnancy after conservative surgical treatment of borderline ovarian tumor with III C stage according to FIGO classification. The caesarean section in 37 week of pregnancy was performed and connected with very precise staging. In normal-appearing both ovaries the foci of borderline ovarian tumor were found. There were no foci of borderline ovarian tumor or foci of invasive carcinoma in tissues routinely sampled during the second look operation. All benefits and costs of conservative surgical approaches to very young, childless women with advanced borderline ovarian tumor were exactly estimated.

Adult↗

Differential diagnosis of small hepatocellular carcinoma and borderline lesions and therapeutic strategy.

BACKGROUND/AIMS: To investigate imaging characteristics and surgical results of adenomatous hyperplasia and early-stage hepatocellular carcinoma. METHODOLOGY: A retrospective study set in the First Department of Surgery, University of Tokushima, Japan. From 1994 to 1997, 33 patients with 55 small hepatocellular carcinomas (< or = 3 cm) and 10 borderline lesions (3 adenomatous hyperplasia, 5 atypical adenomatous hyperplasia, 2 atypical adenomatous hyperplasia with focal malignancy) were enrolled for this study. The detectability of these lesions on imaging was evaluated. Cumulative survival and disease-free survival rates were also calculated. RESULTS: Twenty-eight patients were incidentally diagnosed on ultrasonography during follow-up study for chronic disease. In the conventional studies, detection rates of ultrasonography, computed tomography and angiography for small hepatocellular carcinomas and borderline lesions were 76% 80%, 33% 10% and 36% 20%, respectively. Magnetic resonance imaging, intraoperative ultrasonography, helical computed tomography and portal angiographic computed tomography showed better results of 67% 20%, 100% 90%, 70% 50% and 74% 56%, respectively. On differential diagnosis, the ratio of echo level in small hepatocellular carcinomas was significantly higher than that in borderline lesions. The 3-year and 5-year survival rates for all patients were 61% and 41%, while disease-free survival rates at the corresponding times were 15% and 7%, respectively. A total of 25 patients (76%) developed intrahepatic recurrence during a mean follow-up of 33.8 months, although there was no recurrent lesion in 4 adenomatous hyperplasia patients treated with microwave coagulation therapy and ethanol injection intraoperatively. CONCLUSIONS: For tumors larger than 1 cm in diameter, the detection rates with various diagnostic modalities were rather high. However, the differential diagnosis of borderline lesions from small hepatocellular carcinomas could be based on pathologic studies only. Early detection of small hepatic lesions and treatment by methods such as resection or ethanol injection are of critical importance in improving long-term survival.

Carcinoma, Hepatocellular↗

Borderline ovarian tumors in reproductive-age women. Fertility-sparing surgery and outcome.

OBJECTIVE: To evaluate the fertility and survival outcomes in young women with borderline ovarian tumors treated with fertility-sparing surgery. STUDY DESIGN: From 1985 to 2002, 25 women with borderline ovarian cancers surgically managed with preservation of the uterus and at least a portion of 1 ovary were identified from tumor registry databases at 2 southern California hospitals. Data for analysis were collected from hospital charts, office records and tumor registry files. RESULTS: Twenty-five patients (median age, 29 years) with borderline ovarian tumors, including 10 with stage IA, 3 with stage IC, 1 with stage IIIA and 11 with unstaged disease, underwent fertility-sparing surgery, consisting of unilateral adnexectomy in 19, unilateral adnexectomy with contralateral cystectomy in 5 and unilateral cystectomy in 1. No disease recurred, providing an overall survival of 100%. Fertility status was available on 15 patients 4-157 months after surgery; 6 of them attempted to become pregnant. Five women had successful pregnancies, with a total of 5 live births. One woman underwent assisted reproductive techniques, became pregnant but aborted. The median follow-up was 80 months (range, 4-157). CONCLUSION: Conservative surgery for borderline ovarian tumors should be considered for women in the reproductive age group who desire preservation of fertility.

Adenocarcinoma, Mucinous↗

[Cephalometric comparison of hard-tissue morphology between extraction and non-extraction orthodontic treatment in borderline cases].

OBJECTIVE: To compare hard-tissue morphology by cephalometric measurements between extraction and non-extraction orthodontic treatment in borderline cases. METHODS: The samples consisted of 33 cases selected as borderline cases by 5 orthodontic specialists. They were divided into 21 extraction cases (including 13 four first premolar extraction cases and 8 second premolar extraction cases) and 12 nonextraction cases by checking patients' treatment records. Conventional cephalometric analysis was made to compare hard tissue structures before and after orthodontic treatment and the same comparison was made between two different extraction patterns. RESULTS: No statistical difference was found on pretreatment hard-tissue morphology between extraction and non-extraction groups divided from borderline cases. The SNB angle of the four first premolars extraction group was smaller than that of the four second premolars extraction group by (4.0+/-1.3) degrees P<0.01 . The statistical significant differences of the post-treatment hard-tissue cephalometry between extraction and nonextraction and between two different extraction patterns were found to be limited to the items related to the tooth position. CONCLUSION: Conventional cephalometric analysis cannot differentiate extraction or non-extraction treatment selection from borderline cases. The differences between extraction and non-extraction orthodontic treatments were limited to tooth positions but had no skeletal relation. Extraction of the four second premolars could prevent upper incisors from uprighting as it often follows the four first premolar extraction treatment. Extraction of the four first premolars could change the incisor position much more than extraction of the four second premolars. The changes of four second premolar extraction treatment were much similar to non-extraction treatment.

Cephalometry↗

Long-term outcome of conservatively treated patients with borderline coronary lesions--role of the fractional flow reserve measurement.

BACKGROUND: Coronary fractional flow reserve (FFR) has been recommended as one of the functional methods which can be used to establish indications for revascularisation in patients with borderline coronary lesions. AIM: To assess long-term outcome of patients with borderline coronary lesions in whom the decision to implement conservative treatment was based on the results of FFR. METHODS: The study group consisted of 41 patients (13 females, mean age 61+/-9 years) who had CCS class II angina, an isolated borderline (40-70%) coronary lesion and FFR >0.75. All patients received 40 mg of simvastatin, angiotensin converting enzyme inhibitor and aspirin. The follow-up duration ranged from 7 to 32 months (mean 15.2+/-7.1, median 14.5 months). The analysed end-points included cardiac death, myocardial infarction (MI) (with or without ST segment elevation) and revascularisation of the target coronary artery. RESULTS: The mean FFR value in the whole study group was 0.91+/-0.05. Three (7%) patients had complications during follow-up: one patient developed MI, and two had coronary artery stenosis progression, requiring angioplasty. These patients had similar clinical and angiographic characteristics as well as FFR values as patients without complications. Among patients with uneventful outcome, in 33 (87%) anginal symptoms improved whereas in the remaining 5 (13%) patients CCS class did not change. Patients with angina alleviation were older and had higher FFR values than patients without improvement (63+/-8 vs 48+/-6 years, p=0.0005; and 0.92+/-0.05 vs 0.86+/-0.08, p=0.04, respectively). CONCLUSIONS: In patients with borderline coronary lesions and stable angina, angioplasty can be delayed on the basis of the FFR results. This approach is safe and is associated with an asymptomatic long-term follow-up in more than 90% of patients.

Aged↗