Fractional flow reserve measurement for decision making in multivessel and diffuse coronary artery disease

Abstract

Aim. This study was undertaken to evaluate the role of fractional flow reserve (FFR) measurement in the complex diagnosis and treatment of multivessel coronary artery disease (CAD).
Materials and Methods. 162 patients with CAD were randomized into 2 groups: control angiography (n=82) and FFR-control (n=80). Subsequently, each group was divided into deferred and performed percutaneous coronary intervention (PCI) subgroups. In FFR-control group PCI was performed if FFR was less than 0.80.
Results. In the analysis of the primary endpoint (all-cause mortality, cardiovascular death, nonfatal myocardial infarction, revascularization): the survival of patients without major adverse cardiac events (MACE) in the FFR-control group was significantly higher by 7.5% than in the angiography-control group, 73 (94.8%) vs. 69 (87.3%), p = 0.04. In the analysis of the secondary endpoint, which included the MACE and relapse or progression of angina was found that the survival rate without angina and MACE of patients in FFR-control group was significantly higher by 23.5% than in the angiography-control group, 62 (80.6%), versus 45 (57%), p = 0.0005.
Conclusion. FFR measurement in patients with multivessel disease not only reduces the cost of treatment (reducing the number of stents), with a comparable exposure time and total time of intervention, but also has a positive effect on prognosis in this group of patients.