Long-Term Clinical Outcomes of Fractional Flow Reserve–Guided Versus Routine Drug-Eluting Stent Implantation in Patients With Intermediate Coronary Stenosis
Key result
FFR-guided stenting yields similar 5-year MACE rates compared to routine stenting.
- HR 1.25
- 95% CI 0.60-2.60
- P=0.55
- n=229
Why the study?
Does an FFR-guided strategy improve long-term clinical outcomes compared to routine DES implantation in patients with intermediate coronary stenosis?
Population
n=229 patients with an angiographically intermediate coronary stenosis
Comparison
Fractional flow reserve-guided strategy vs Routine DES implantation without FFR measurement
Design
RCT, randomly assigned
Follow-up
5 years
Authors
Discussion
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Member takes
Implication
Supports safe deferral of stenting for FFR-negative intermediate lesions; extends RCT evidence for physiology-guided PCI.
Study Design
Type
RCT (n=229)
Structured PICO
Does an FFR-guided strategy improve long-term clinical outcomes compared to routine DES implantation in patients with intermediate coronary stenosis?
P
Population
229 patients with an angiographically intermediate coronary stenosis followed for up to 5 years.
I
Intervention
Fractional flow reserve (FFR)-guided strategy (drug-eluting stent [DES] implantation if FFR <0.75; deferral of stenting if FFR ≥0.75)
C
Comparator
Routine DES implantation without FFR measurement
O
Outcome
Incidence of major adverse cardiac events, a composite of cardiac death, myocardial infarction, and target lesion revascularizationcomposite
Main Result
Hazard Ratio: 1.25 (95% CI 0.6–2.6)
Absolute Event Rate: 11.6% vs 14.2%
p-value: p=0.55
FFR-guided stenting for intermediate coronary stenosis yields similar long-term clinical outcomes to routine stenting while avoiding unnecessary interventions in a significant proportion of patients.
Cite This Study
Park et al. (2015) conducted an RCT in Intermediate coronary stenosis (n=229). Fractional flow reserve (FFR)-guided drug-eluting stent (DES) implantation vs. Routine drug-eluting stent (DES) implantation was evaluated on Incidence of major adverse cardiac events, a composite of cardiac death, myocardial infarction, and target lesion revascularization (HR 1.25, 95% CI 0.60-2.60, p=0.55). Fractional flow reserve (FFR)-guided stenting yielded similar 5-year rates of major adverse cardiac events compared to routine stenting (11.6% vs 14.2%; HR 1.25, 95% CI 0.60-2.60; P=0.55).