One-year outcome of patients submitted to routine fractional flow reserve assessment to determine the need for...

Area of Science:

• Cardiology
• Interventional Cardiology
• Diagnostic Imaging

Background:

• Fractional flow reserve (FFR) using a pressure wire aids revascularization decisions during coronary angiography.
• Routine FFR application and its impact on 1-year outcomes are not well-documented.
• This study reports a 4-year single-centre experience encouraging FFR use for equivocal lesions.

Purpose of the Study:

• To evaluate the feasibility, safety, and impact of routine Fractional Flow Reserve (FFR) assessment in guiding revascularization decisions.
• To analyze the 1-year clinical outcomes of patients undergoing FFR assessment.
• To assess the impact of adhering to FFR results on patient management and outcomes.

Main Methods:

• A prospective registry collected data on 407 patients (469 lesions) undergoing FFR assessment over 4 years.
• FFR was measured using diagnostic catheters, with a revascularization cut-off of 0.80.
• One-year clinical follow-up was obtained for 99% of patients.

Main Results:

• FFR was performed in 6.3% of 6415 coronary angiographies.
• Two-thirds (67%) of patients with intermediate lesions were managed with medical therapy alone based on FFR results (median FFR: 0.87).
• Patients treated according to FFR results showed significantly better 1-year outcomes (85% event-free survival) compared to those not treated according to FFR.

Conclusions:

• Routine FFR assessment during diagnostic angiography is feasible and safe, performed in 6.3% of cases.
• FFR effectively identifies patients with intermediate lesions who can be safely managed non-invasively (FFR > 0.80).
• Adherence to FFR guidance improves 1-year clinical outcomes in patients with coronary artery disease.