Key result
Fractional flow reserve assessment in intermediate coronary lesions showed a weak negative correlation with angiographic stenosis diameter (r=-0.245, p=0.038) and altered PCI decision-making.
Why the study?
Does fractional flow reserve (FFR) assessment alter the decision for myocardial revascularization in patients with intermediate coronary stenosis compared to angiography alone?
Observational (n=72)
Does fractional flow reserve (FFR) assessment alter the decision for myocardial revascularization in patients with intermediate coronary stenosis compared to angiography alone?
Effect estimate: r=-0.245
p-value: p=0.038
FFR assessment in catheterization laboratories without on-site surgical backup significantly alters revascularization decisions for intermediate lesions, primarily by reducing unnecessary PCIs.
Supports physiologic over anatomic assessment in intermediate lesions; leaves open whether FFR-driven PCI changes affect outcomes.
Background: Coronary artery disease is the most common cause of death in a modern world.This dictates the development a network of Catheterization laboratories without cardiosurgical capabilities. Aim:We postulate that the most valuable tool in the decision process on myocardial revascularization is fractional flow reserve (FFR), especially when we deal with borderline coronary lesions. Material and Methods:A total of 72 patients with 94 intermediate coronary stenosis (30%-70% diameter reduction) were included in this study.We tested FFR and angiography based decision model on myocardial revascularization.Results: Mean FFR value on left anterior descending coronary artery (LAD) was lower than in others two arteries (p=0.017).FFR after percutaneous coronary intervention (PCI) was significantly better (p<0.0001).The decision for PCI predominates before FFR diagnostics, but after FFR the decision is quite opposite.There is a weak negative correlation between FFR and diameter of stenosis assessed by angiography (r= -0.245 p=0.038) and positive correlation between diameter of stenosis assessed by angiography and by quantitative coronary angiography (QCA) (r=0.406p<0.0005). Conclusion:Our results strongly suggest that FFR is necessary tool in centers without possibilities of heart team onsite consultation and that prevents numerous unnecessary PCI.
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Ivan Simić (2013) conducted an observational in Intermediate coronary stenosis (n=72). Fractional flow reserve (FFR) vs. Angiography was evaluated on Correlation between FFR and diameter of stenosis assessed by angiography (r=-0.245, p=0.038). Fractional flow reserve assessment in intermediate coronary lesions showed a weak negative correlation with angiographic stenosis diameter (r=-0.245, p=0.038) and altered PCI decision-making.
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