Fractional flow reserve in consecutive “real-world” patients




Background


Fractional flow reserve (FFR) is an invasive physiological index of the functional severity of coronary artery stenoses. Trial data have demonstrated that an FFR>0.80 predicts excellent clinical outcomes in medically managed patients. There is however limited information on how these trials translate to unselected “real-world” patients.




Aim


The aim was to determine the longer-term clinical outcome among consecutive patients with angiographic coronary artery disease (CAD) in whom coronary angiography demonstrated non-flow-limiting stenoses (FFR>0.80) and who did not undergo percutaneous coronary intervention (PCI).




Aim


The aim was to determine the longer-term clinical outcome among consecutive patients with angiographic coronary artery disease (CAD) in whom coronary angiography demonstrated non-flow-limiting stenoses (FFR>0.80) and who did not undergo percutaneous coronary intervention (PCI).




Method


Clinical outcomes were assessed in patients with FFR>0.80 who did not undergo PCI and included presence of anginal chest pain, need for revascularization or death during a median follow-up of 17±9 months.




Results


A total of 325 lesions were interrogated in 273 consecutive patients. FFR was >0.80 (mean 0.89±0.05) in 190 patients (69.6%) and 228 lesions (83.5%). Comorbidities included diabetes mellitus (15.8%), dyslipidemia (54.2%), hypertension (54.7%) and smoking (33.7%). Lesions were in the LAD in 52.9%, circumflex in 24.6%, RCA in 15.8% and left main stem in 6.6%. Recurrence of angina was seen in 10.5% of patients, with 5.8% reporting atypical chest pain. No myocardial infarction was noted. Revascularization was required in 6.3%, with one cardiovascular death (0.5%) due to heart failure.

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Nov 16, 2017 | Posted by in CARDIOLOGY | Comments Off on Fractional flow reserve in consecutive “real-world” patients

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