Association Between Adherence to Fractional Flow Reserve Treatment Thresholds and Major Adverse Cardiac Events in Patients With Coronary Artery Disease
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View abstract on PubMed
Summary
This summary is machine-generated.Adhering to fractional flow reserve (FFR) thresholds for percutaneous coronary intervention (PCI) improves outcomes. PCI reduced major adverse cardiac events (MACE) in ischemic lesions but increased MACE in non-ischemic lesions.
Area Of Science
- Cardiology
- Interventional Cardiology
- Clinical Outcomes Research
Background
- Fractional flow reserve (FFR) is crucial for guiding percutaneous coronary intervention (PCI) decisions in coronary artery disease.
- Evidence-based FFR thresholds exist, but adherence in routine practice and its impact on clinical outcomes remain unclear.
Purpose Of The Study
- To evaluate adherence to established FFR thresholds for PCI in routine practice.
- To determine if adherence to FFR thresholds is associated with clinical outcomes.
Main Methods
- Retrospective, multicenter, population-based cohort study in Ontario, Canada (2013-2019).
- Included adults with coronary artery disease undergoing single-vessel FFR assessment.
- Used inverse probability of treatment weighting to adjust for treatment selection bias.
Main Results
- Among 9106 patients, PCI for ischemic FFR (≤0.80) was associated with significantly lower 5-year MACE compared to medical therapy alone (31.5% vs 39.1%).
- PCI for non-ischemic FFR (>0.80) was associated with significantly higher 5-year MACE compared to medical therapy alone (33.3% vs 24.4%).
Conclusions
- Performing PCI according to evidence-based FFR thresholds is associated with improved clinical outcomes.
- Adherence to FFR guidance in routine practice is supported by these findings, reducing MACE for appropriate indications and avoiding harm for inappropriate ones.
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