One-year outcome of patients submitted to routine fractional flow reserve assessment to determine the need for angioplasty
| Autor: | Hu Wei, Nicolas Meneveau, Marie-France Seronde, Fiona Caulfield, Marie-Cecile Blonde, Jean-Pierre Bassand, Pierre Legalery, Francois Schiele, Katy Didier |
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| Rok vydání: | 2005 |
| Předmět: |
Male
medicine.medical_specialty Acute coronary syndrome Time Factors medicine.medical_treatment Decision Making Fractional flow reserve Revascularization Coronary Angiography Internal medicine Angioplasty Coronary Circulation Myocardial Revascularization Medicine Humans Prospective Studies Prospective cohort study Referral and Consultation Survival analysis business.industry Coronary Stenosis Stent Middle Aged medicine.disease Prognosis Survival Analysis Diagnostic catheterization Regional Blood Flow Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | European heart journal. 26(24) |
| ISSN: | 0195-668X |
| Popis: | Aims In patients submitted to coronary angiography, fractional flow reserve (FFR) assessment by a pressure wire can be used to guide the decision for revascularization. Routine application of FFR assessment and 1-year outcome of patients are poorly documented. The aim of this study was to report a 4-year single-centre experience where the use of FFR for decision making in equivocal lesions is encouraged. Methods and results A prospective registry was designed to collect clinical and angiographic characteristics, as well as 1-year clinical follow-up for all patients submitted to FFR assessment. The decisional cut-off point for revascularization was 0.80. Over a 4-year period, out of 6415 coronary angiographies, FFR was measured in 407 (6.3%) patients (469 lesions). FFR was assessed through 4 or 5 Fr diagnostic catheters in 330 (81%). Median FFR value was 0.87 (0.80; 0.93). On the basis of FFR results, 271 (67%) patients were treated with medical therapy alone. A subset of 71 (17%) patients were not treated in accordance with the results of FFR. All patients but four (i.e. 99%) had 1-year clinical follow-up. Three hundred and forty four (85%) were free from clinical event, six (1.5%) patients died, five (4%) had an acute coronary syndrome, and 20 (5%) underwent target-vessel revascularization. Event-free survival was comparable in patients with vs. without revascularization (0.94+ 0.02 and 0.93+ 0.01, respectively). Patients had significantly better 1-year outcome when treated in accordance with the results of the FFR assessment. Conclusion In routine practice, FFR assessment during diagnostic angiography was performed in 6.3%. On the basis of FFR, two-thirds of patients with ‘intermediate’ lesions were left unrevascularized, with a favourable outcome, when FFR was above 0.80. These data suggest that routine use of FFR during diagnostic catheterization is feasible, safe, and provide help to guide decision making. |
| Databáze: | OpenAIRE |
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