Does deferral of PCI compared to performance of PCI improve or maintain event-free survival in patients with intermediate coronary stenosis and FFR ≥0.75?
Deferring PCI for intermediate coronary stenoses that are functionally nonsignificant (FFR ≥0.75) is safe and yields excellent 5-year outcomes without the need for stenting.
OBJECTIVES: The purpose of this study was to investigate the appropriateness of stenting a functionally nonsignificant stenosis. BACKGROUND: Percutaneous coronary intervention (PCI) of an intermediate stenosis without evidence of ischemia is often performed, but its benefit is unproven. Coronary pressure-derived fractional flow reserve (FFR) is an invasive index used to identify a stenosis responsible for reversible ischemia. METHODS: In 325 patients scheduled for PCI of an intermediate stenosis, FFR was measured just before the planned intervention. If FFR was >or =0.75, patients were randomly assigned to deferral (Defer group; n = 91) or performance (Perform group; n = 90) of PCI. If FFR was /=0.75 is excellent. The risk of cardiac death or myocardial infarction related to this stenosis is <1% per year and not decreased by stenting.
Pijls et al. (Tue,) studied this question.
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