Related Experiment Video

Updated: Oct 14, 2025

Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats
06:32

Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats

Published on: June 28, 2019

8.2K

Fractional Flow Reserve to Guide Treatment of Patients With Multivessel Coronary Artery Disease

Gilles Rioufol1, François Dérimay1, François Roubille2

  • 1Hôpital Cardiologique et Pneumologique Louis Pradel, Hospices Civils de Lyon, Bron, France.

Journal of the American College of Cardiology
|November 5, 2021
PubMed

Insights

Fractional flow reserve (FFR) guidance did not reduce major adverse cardiac events in multivessel coronary artery disease (CAD). The FUTURE trial found FFR reduced revascularization rates but showed no significant difference in ischemic events or death.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Trials

Background:

  • Limited evidence exists on the effectiveness of fractional flow reserve (FFR) in guiding treatment strategies for multivessel coronary artery disease (CAD).
  • Previous studies have not conclusively established FFR's role beyond selecting candidates for percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG).

Purpose of the Study:

  • To evaluate if an FFR-guided treatment strategy is superior to a traditional strategy without FFR in managing multivessel CAD.
  • To assess the impact of FFR on major adverse cardiac or cerebrovascular events (MACCE) and revascularization rates.

Main Methods:

  • The FUTURE trial was a prospective, randomized, open-label superiority trial involving patients with multivessel CAD.
  • Participants were randomized to an FFR-guided strategy (revascularization for lesions with FFR ≤0.80) or a traditional strategy.
  • The primary endpoint was a composite of MACCE at 1-year follow-up.

Main Results:

  • The trial was stopped prematurely; 927 patients were enrolled.
  • No significant difference in MACCE rates was observed between the FFR-guided group (14.6%) and the control group (14.4%) at 1 year (HR: 0.97; 95% CI: 0.69-1.36).
  • FFR significantly reduced revascularization rates (P=0.02), leading to more patients receiving medical management.

Conclusions:

  • An FFR-guided treatment strategy did not demonstrate superiority over a traditional approach in reducing ischemic cardiovascular events or death in patients with multivessel CAD at 1-year follow-up.
  • While FFR effectively reduced revascularization procedures, it did not translate to improved clinical outcomes regarding major adverse events.
Abstract

Keywords:
coronary artery diseasecoronary revascularization strategyfractional flow reserve

More Related Videos

Author Spotlight: Improved Localization and Monitoring of Coronary Flow Reserve Using Modified PLAX View in Mice05:07

Author Spotlight: Improved Localization and Monitoring of Coronary Flow Reserve Using Modified PLAX View in Mice

Published on: August 25, 2023

1.4K
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

5.3K

Related Concept Videos

Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
67
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

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...
49
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
53
Angina IV: Management01:26

Angina IV: Management

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...
48
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

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...
49
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
54