Related Experiment Video
Updated: May 4, 2026
06:32
Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats
Published on: June 28, 2019
7.7K
Fractional flow reserve vs. angiography in guiding management to optimize outcomes in non-ST-segment elevation
Jamie Layland1, Keith G Oldroyd2, Nick Curzen3
1West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK.
European Heart Journal
|September 3, 2014
Summary
Fractional flow reserve (FFR)-guided management in non-ST segment elevation myocardial infarction (NSTEMI) patients led to less revascularization than standard angiography guidance. Further trials are needed to confirm health outcomes and cost-effectiveness.
Area of Science:
- Cardiology
- Interventional Cardiology
- Clinical Trials
Background:
- Non-ST segment elevation myocardial infarction (NSTEMI) management involves complex decisions regarding revascularization.
- Fractional flow reserve (FFR) is a physiological measure used to assess the hemodynamic significance of coronary stenoses.
- Current guidelines recommend FFR for guiding revascularization in select cases.
Purpose of the Study:
- To compare the management and outcomes of NSTEMI patients managed with FFR-guided therapy versus standard angiography-guided care.
- To determine if FFR disclosure influences treatment decisions and subsequent revascularization rates.
- To evaluate the impact of FFR-guided management on patient health outcomes and quality of life.
Main Methods:
- A prospective, multicenter, randomized controlled trial involving 350 NSTEMI patients.
- Patients were randomly assigned (1:1) to either FFR-guided management (FFR disclosed) or angiography-guided standard care (FFR measured but not disclosed).
- Revascularization was indicated if FFR ≤0.80, using percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG).
Main Results:
- The FFR-guided group had a higher proportion of patients initially treated with medical therapy (22.7% vs. 13.2%, P=0.022).
- FFR disclosure altered treatment plans in 21.6% of patients.
- At 12 months, revascularization rates were lower in the FFR-guided group (79.0% vs. 86.8%, P=0.054).
- No significant differences in health outcomes or quality of life were observed between the groups.
Conclusions:
- Angiography-guided management in NSTEMI patients was associated with higher rates of coronary revascularization compared to FFR-guided management.
- FFR-guided management may reduce revascularization rates without compromising short-term health outcomes.
- A larger trial is warranted to definitively assess health outcomes and cost-effectiveness.
Keywords:
Acute coronary syndromeCoronary revascularizationFractional flow reserveMedical therapyNon-ST elevation myocardial infarctionMore Related Videos
Related Concept Videos
01:28Acute Coronary Syndrome IV: Interprofessional Care
522
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
522
01:26Angina IV: Management
493
IntroductionThe management of angina requires a comprehensive approach that includes pharmacological therapies, medical procedures, and lifestyle modifications.Pharmacological TherapiesAntiplatelet agents, such as aspirin, clopidogrel, prasugrel, and ticagrelor, play a pivotal role in preventing thrombus formation in patients with angina. These medications inhibit platelet aggregation and reduce the likelihood of myocardial infarction and other cardiovascular events.Anticoagulants, including...
493
01:20Angina V: Nursing Management
565
Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...
565
01:30Heart Failure V: Medical Management
626
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
626