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January 1, 2018Arquivos Brasileiros de CardiologiaOpen Access

Clinical Outcomes and Cost-Effectiveness Analysis of FFR Compared with Angiography in Multivessel Disease Patient

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Key result

FFR-guided angioplasty significantly reduced the number of stents per lesion compared to angiography (0.45 vs 1.05; p=0.0001) with comparable cost-effectiveness.

Why the study?

Does FFR-guided angioplasty improve clinical outcomes and cost-effectiveness compared to angiography-guided angioplasty in patients with multivessel disease?

Population

69 patients with multivessel disease, mean age 62.0 ± 9.0 years, 68.1% men.

Comparison

Fractional flow reserve-guided angioplasty using… vs Angiography-guided angioplasty using…

Design

RCT, prospectively randomized

Follow-up

< 12 months

Authors

EQEdgard Freitas QuintellaUniversidade de São PauloEFEsmeralci FerreiraUniversidade do Estado do Rio de JaneiroVAVitor Manuel Pereira AzevedoUniversidade Federal do Rio de Janeiro

Discussion

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Implication

Supports FFR to minimize stents in multivessel disease without added cost; extends RCT evidence for physiology-guided PCI.

Study Design

Type

RCT (n=69)

Randomization

prospectively randomized

Structured PICO

Does FFR-guided angioplasty improve clinical outcomes and cost-effectiveness compared to angiography-guided angioplasty in patients with multivessel disease?

P
Population
69 patients with multivessel disease (stable angina or acute coronary syndrome), mean age 62.0 ± 9.0 years, 68.1% men.
I
Intervention
Fractional flow reserve (FFR)-guided angioplasty using non-pharmacological stents
C
Comparator
Angiography-guided angioplasty using non-pharmacological stents
O
Outcome
Major adverse cardiac events (MACE), restenosis, and cost-effectiveness at < 12 monthscomposite

FFR-guided PCI in multivessel disease reduces the number of stents deployed without compromising clinical outcomes or cost-effectiveness compared to angiography alone.

Cite This Study

Quintella et al. (2018) conducted an RCT in Multivessel disease with moderate stenosis (n=69). FFR-guided angioplasty vs. Angiography-guided angioplasty was evaluated on Major adverse cardiac events (MACE), restenosis and cost-effectiveness (CE). FFR-guided angioplasty significantly reduced the number of stents per lesion compared to angiography (0.45 vs 1.05; p=0.0001) with comparable cost-effectiveness.

synapsesocial.com/papers/6a11bed64bf0131c39178c32https://doi.org/10.5935/abc.20180262
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Fractional flow reserve versus angiography for guiding percutaneous coronary intervention: a meta-analysis2015 · 95 citations
  2. 2Long-term outcome of FFR-guided PCI for stable coronary artery disease in daily clinical practice: a propensity score-matched landmark analysis2016 · 22 citations
  3. 3Percutaneous Coronary Intervention of Functionally Nonsignificant Stenosis2007 · 1,516 citations
  4. 4Optimal Medical Therapy With or Without Percutaneous Coronary Intervention to Reduce Ischemic Burden2008 · 1,608 citations
  5. 5Angiographic Versus Functional Severity of Coronary Artery Stenoses in the FAME Study2010 · 1,249 citations