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Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
963
Role of Invasive Functional Assessment in Surgical Revascularization of Coronary Artery Disease
Bipul Baibhav1,2, Maheedhar Gedela3, Michael Moulton4
1Cardiovascular Division (B.B., G.P. V.P., Y.S.C.).
Circulation
|April 18, 2018
Summary
Invasive functional assessment, like fractional flow reserve, improves outcomes for coronary artery disease patients undergoing percutaneous coronary intervention. Its role in guiding coronary artery bypass grafting surgery is under investigation.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiovascular Surgery
Background:
- Percutaneous coronary intervention (PCI) outcomes improve with significant lesions identified by invasive functional assessment (e.g., fractional flow reserve).
- Instantaneous wave-free ratio (iFR) is noninferior to fractional flow reserve (FFR) for intermediate stenoses.
- Coronary artery bypass grafting (CABG) decisions primarily rely on anatomical assessment via coronary angiography.
Purpose of the Study:
- To review the diagnostic and prognostic significance of invasive functional assessment in patients considered for CABG.
- To critically discuss current and future clinical trials evaluating invasive functional assessment in guiding surgical revascularization.
Main Methods:
- Literature review of studies on invasive functional assessment in coronary artery disease.
- Analysis of diagnostic and prognostic data related to FFR and iFR in the context of CABG.
- Discussion of ongoing and future clinical trials.
Main Results:
- Invasive functional assessment is established for guiding PCI in stable coronary artery disease.
- Limited data currently exist on the role of invasive functional assessment in guiding CABG.
- Ongoing trials aim to clarify the utility of functional assessment in surgical decision-making.
Conclusions:
- Invasive functional assessment plays a crucial role in optimizing PCI outcomes.
- Further research and clinical trials are necessary to establish the role of invasive functional assessment in guiding CABG.
- Understanding the diagnostic and prognostic value of functional assessment is key for future revascularization strategies.
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