[Coronary artery disease diagnostic with fractional flow reserve]

C Trana1, O Muller, E Eeckhout

  • 1Service de cardiologie, Département de médecine interne, CHUV, 1011 Lausanne. catalina.trana@chuv.ch

Insights

Fractional flow reserve (FFR) guides decisions for coronary artery stenosis. Revascularization for stable angina is deferred if FFR is greater than 0.8, improving patient outcomes.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Imaging

Context:

  • Fractional flow reserve (FFR) is an invasive diagnostic tool used in cardiac catheterization labs.
  • It assesses the hemodynamic significance of coronary artery blockages when non-invasive tests are inconclusive or unavailable.
  • FFR is valuable in managing intermediate coronary lesions, complex bifurcations, left main stenosis, and multivessel coronary artery disease.

Purpose:

  • To evaluate the role of invasive coronary physiology, specifically FFR, in guiding clinical decision-making for coronary artery disease.
  • To determine the threshold for deferring revascularization procedures based on FFR measurements in patients with stable angina.

Summary:

  • FFR is a pressure-derived index assessing epicardial stenosis severity during cardiac catheterization.
  • Invasive coronary physiology improves outcomes in patients with intermediate single-vessel disease, left main stenosis, complex bifurcations, and multivessel coronary artery disease.
  • Revascularization (PCI or CABG) for stable angina should be deferred if epicardial coronary stenosis has an FFR > 0.8.

Impact:

  • FFR-guided decision-making optimizes treatment strategies for coronary artery disease, potentially reducing unnecessary interventions.
  • Demonstrates favorable outcomes in specific patient subgroups, including those with intermediate lesions and complex coronary anatomy.
  • Establishes a clear FFR threshold (>0.8) for deferring revascularization in stable angina, promoting evidence-based practice.

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