Usefulness of Fractional Flow Reserve during Routine Clinical Procedures in All-Comer Coronary Artery Disease Patients  

作　　者：Sridhar Kasturi Shailender Singh Vijay Kumar Reddy Shanivaram Manikandhar Pendyala Chandrashekar Challa Sridhar Kasturi;Shailender Singh;Vijay Kumar Reddy Shanivaram;Manikandhar Pendyala;Chandrashekar Challa(Department of Cardiology, Sunshine Heart Institute, Secunderabad, Hyderabad, Telangana)

机构地区：[1]Department of Cardiology, Sunshine Heart Institute, Secunderabad, Hyderabad, Telangana

出　　处：《World Journal of Cardiovascular Diseases》2021年第11期509-522,共14页心血管病（英文）

摘　　要：<strong>Background:</strong><span style="white-space:normal;font-family:;" "=""> Fractional flow reserve (FFR)</span><span style="white-space:normal;font-family:;" "="">-</span><span style="white-space:normal;font-family:;" "="">guided interventions</span><span style="white-space:normal;font-family:;" "="">, </span><span style="white-space:normal;font-family:;" "="">though proved to be safe, continue</span><span style="white-space:normal;font-family:;" "=""> </span><span style="white-space:normal;font-family:;" "="">to be a much-underutilized modality in determining treatment strategy, and data is lacking in Indian population. <b>Objective:</b> We aimed to determine the use of FFR-guided PCI and assess the overall impact on treatment decisions and clinical outcomes in patients with acute coronary syndrome (ACS) or chronic coronary syndromes (CCS). <b>Methods:</b> In this single-center retrospective and prospective observational study, FFR had been performed for the evaluation of treatment reclassification and clinical outcomes, as per physician’s clinical practice. <b>Results: </b>Data was obtained for 250 subjects (mean age 60.45 ± 9.6 years) with 324 lesions. The treatment plan based on angiography alone changed in 28% of lesions post-hyperemic FFR. The initial treatment plan based on angiography vs. the final treatment plan post-FFR (>0.80) was medical management 56.5% vs. 66.0%;CABG 11.1% vs.</span><span style="white-space:normal;font-family:;" "=""> </span><span style="white-space:normal;font-family:;" "="">7.7%;and PCI 32.4% vs</span><span style="white-space:normal;font-family:;" "="">.</span><span style="white-space:normal;font-family:;" "=""> 26.2%. In subjects initially assigned to medical management, 14% had changed to PCI, and for subjects initially assigned to PCI, 44% had changed to medical therapy. Receiver operating characteristics (ROC) curve analysis revealed a good correlation between a resting FFR value of <0.87 and hyperemic FFR value of <0.80. The rate of 2-year major adverse cardiovasc<strong>Background:</strong><span style="white-space:normal;font-family:;" "=""> Fractional flow reserve (FFR)</span><span style="white-space:normal;font-family:;" "="">-</span><span style="white-space:normal;font-family:;" "="">guided interventions</span><span style="white-space:normal;font-family:;" "="">, </span><span style="white-space:normal;font-family:;" "="">though proved to be safe, continue</span><span style="white-space:normal;font-family:;" "=""> </span><span style="white-space:normal;font-family:;" "="">to be a much-underutilized modality in determining treatment strategy, and data is lacking in Indian population. <b>Objective:</b> We aimed to determine the use of FFR-guided PCI and assess the overall impact on treatment decisions and clinical outcomes in patients with acute coronary syndrome (ACS) or chronic coronary syndromes (CCS). <b>Methods:</b> In this single-center retrospective and prospective observational study, FFR had been performed for the evaluation of treatment reclassification and clinical outcomes, as per physician’s clinical practice. <b>Results: </b>Data was obtained for 250 subjects (mean age 60.45 ± 9.6 years) with 324 lesions. The treatment plan based on angiography alone changed in 28% of lesions post-hyperemic FFR. The initial treatment plan based on angiography vs. the final treatment plan post-FFR (>0.80) was medical management 56.5% vs. 66.0%;CABG 11.1% vs.</span><span style="white-space:normal;font-family:;" "=""> </span><span style="white-space:normal;font-family:;" "="">7.7%;and PCI 32.4% vs</span><span style="white-space:normal;font-family:;" "="">.</span><span style="white-space:normal;font-family:;" "=""> 26.2%. In subjects initially assigned to medical management, 14% had changed to PCI, and for subjects initially assigned to PCI, 44% had changed to medical therapy. Receiver operating characteristics (ROC) curve analysis revealed a good correlation between a resting FFR value of <0.87 and hyperemic FFR value of <0.80. The rate of 2-year major adverse cardiovasc

关 键 词：ANGIOGRAM Fractional Flow Reserve Percutaneous Coronary Intervention Coronary Physiology 

分 类 号：R54[医药卫生—心血管疾病]