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Clinical value of fractional flow reserve in coronary heart disease: A retrospective study
Liying Zhang1, Dingxiong Xie1, Yirong Gan1
1Gansu Institute of Cardiovascular Diseases, Lanzhou, China.
Insights
Combining coronary arteriography (CAG) with fractional flow reserve (FFR) significantly reduces surgical treatment for coronary heart disease (CHD). This approach prevents overtreatment and guides precise interventions for patients with significant coronary artery stenosis.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
Background:
- Coronary heart disease (CHD) remains a leading cause of mortality worldwide.
- Accurate assessment of coronary artery stenosis is crucial for effective treatment decisions.
- Over-reliance on anatomical stenosis alone can lead to inappropriate interventions.
Purpose of the Study:
- To evaluate the clinical utility of combining coronary arteriography (CAG) with fractional flow reserve (FFR) in managing CHD patients.
- To determine if FFR measurement can reduce unnecessary surgical interventions in patients with severe coronary artery stenosis (>70%).
Main Methods:
- A retrospective analysis of 344 CHD patients treated between January 2020 and May 2022.
- Patients were divided into a CAG group (n=138) and a CAG+FFR group (n=206).
- FFR measurements were used to guide intervention decisions in patients with >70% stenosis.
Main Results:
- The CAG+FFR group had a 44.72% reduction in surgical treatment rates compared to the CAG group.
- Fewer stents were placed in the CAG+FFR group, indicating a decrease in overtreatment.
- No significant difference in major adverse cardiovascular events (MACE) was observed between the groups at 6-month follow-up.
Conclusions:
- Combined CAG and FFR assessment provides precise guidance for CHD treatment, significantly reducing surgical intervention rates.
- FFR measurement is a valuable tool for preventing overtreatment in patients with coronary artery stenosis.
- This combined approach ensures appropriate patient selection for coronary intervention, improving treatment efficiency.
Abstract:
This study investigated the clinical value of coronary arteriography (CAG) combined with fractional flow reserve (FFR) in the treatment of coronary heart disease (CHD) with coronary artery stenosis exceeding 70%. A retrospective analysis was conducted on 344 patients with CHD treated at the Gansu Institute of Cardiovascular Science from January 2020 to May 2022. The patients were divided into the CAG group (n = 138) and the CAG + FFR group (n = 206). Among these patients, those with coronary artery stenosis exceeding 70% underwent an FFR functional examination to accurately determine indicators for coronary intervention. The data collected included demographic information, number of stents, number of vascular lesions, treatment methods, and the occurrence of major adverse cardiovascular events (MACE) at the 6-month follow-up. No significant differences were found between the 2 groups in terms of age, gender, underlying diseases, body mass index (BMI), smoking history, and blood lipid profile. The rate of surgical treatment in the CAG group and the CAG + FFR group was 88.41% and 43.69%, respectively. The CAG + FFR group showed a 44.72% reduction in the need for surgical treatment and a reduced number of stents placed, which helped prevent overtreatment. Additionally, there was no statistical difference between the 2 groups in MACE such as angina pectoris, myocardial infarction, and sudden cardiac death at the 6-month follow-up. After combined CAG examination with FFR measurement, the number of CHD patients with coronary artery stenosis exceeding 70% requiring surgical intervention decreased by 44.72%. FFR could significantly prevent overtreatment and provide more precise guidance for CHD treatments.
