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Prognostic significance of compliance with fractional flow reserve guidance on diverse vessel-related clinical
Yang Zhang1, Bangguo Yang2, Yicong Ye1
1Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Frontiers in Cardiovascular Medicine
|June 3, 2024
Summary
Fractional flow reserve (FFR) guided treatment significantly reduces target vessel failure in coronary artery disease (CAD) patients. However, non-target vessel events can dilute the overall benefit, making composite endpoints appear non-significant.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Adverse events occur in vessels not assessed by fractional flow reserve (FFR).
- The impact of non-target vessel events on FFR-derived benefits is unclear.
Purpose of the Study:
- To investigate the association between FFR-based treatment compliance and long-term clinical outcomes.
- To evaluate the impact of non-target vessel failure (NTVF) on vessel-oriented composite endpoints (VOCEs).
Main Methods:
- Retrospective study of 1,119 vessels undergoing FFR assessment.
- Comparison of FFR-based treatment versus non-compliance using inverse probability of treatment weighting (IPTW).
- Assessment of 5-year target vessel failure (TVF), NTVF, and VOCEs.
Main Results:
- FFR-based treatment was associated with a significantly lower hazard of TVF (HR: 0.56; 95% CI: 0.34-0.92).
- No significant intergroup differences were found for NTVF (HR: 1.02; 95% CI: 0.45-2.31) or VOCEs (HR: 0.69; 95% CI: 0.45-1.05) after adjustment.
Conclusions:
- FFR-guided treatment provides sustained benefits for target vessel-related events in CAD patients.
- Non-target vessel events can dilute the observed benefits of FFR-based approaches when considering composite endpoints.
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