AIMS: We evaluated the impact of the routine use of fractional flow reserve (FFR) on the practice and outcomes of percutaneous coronary intervention (PCI). METHODS AND RESULTS: Between January 2008 and December 2011, the rate of FFR use during PCI increased from 1.9 to 50.7% after the introduction of routine FFR use (P < 0.001). A total of 5097 patients (2699 patients before and 2398 after the routine use of FFR) underwent PCI at an academic hospital in Korea; of those, stent implantation was deferred in 475 patients. We used propensity score (PS) matching to compare the rates of the primary endpoint [death, myocardial infarction (MI), or repeat revascularization] at 1 year the cohort before and after the routine use of FFR. In the PS-matched cohort (2178 pairs), the median number of lesions per patient was 2 [inter-quartile range (IQR) 1-2] before vs. 2 (IQR 1-2) after the routine FFR use (P = 0.68); the median number of stents implanted per patient was 2 (IQR 1-3) vs. 1 (IQR 1-2), respectively (P < 0.001). The rates of the primary endpoint at 1 year was significantly lower in patients after the routine FFR use vs. patients before the routine use of FFR (hazard ratio 0.55; 95% confidence interval 0.43-0.70; P < 0.001). This was primarily due to a reduction in peri-procedural MI and repeat revascularization. CONCLUSION: Routine measurement of FFR in daily practice appeared to be associated with less use of stents and an improvement in clinical outcomes. CLINICALTRIALSGOV NUMBER: NCT 01788592.
AIMS: We evaluated the impact of the routine use of fractional flow reserve (FFR) on the practice and outcomes of percutaneous coronary intervention (PCI). METHODS AND RESULTS: Between January 2008 and December 2011, the rate of FFR use during PCI increased from 1.9 to 50.7% after the introduction of routine FFR use (P < 0.001). A total of 5097 patients (2699 patients before and 2398 after the routine use of FFR) underwent PCI at an academic hospital in Korea; of those, stent implantation was deferred in 475 patients. We used propensity score (PS) matching to compare the rates of the primary endpoint [death, myocardial infarction (MI), or repeat revascularization] at 1 year the cohort before and after the routine use of FFR. In the PS-matched cohort (2178 pairs), the median number of lesions per patient was 2 [inter-quartile range (IQR) 1-2] before vs. 2 (IQR 1-2) after the routine FFR use (P = 0.68); the median number of stents implanted per patient was 2 (IQR 1-3) vs. 1 (IQR 1-2), respectively (P < 0.001). The rates of the primary endpoint at 1 year was significantly lower in patients after the routine FFR use vs. patients before the routine use of FFR (hazard ratio 0.55; 95% confidence interval 0.43-0.70; P < 0.001). This was primarily due to a reduction in peri-procedural MI and repeat revascularization. CONCLUSION: Routine measurement of FFR in daily practice appeared to be associated with less use of stents and an improvement in clinical outcomes. CLINICALTRIALSGOV NUMBER: NCT 01788592.
Authors: Colin Berry; David Corcoran; Barry Hennigan; Stuart Watkins; Jamie Layland; Keith G Oldroyd Journal: Eur Heart J Date: 2015-06-02 Impact factor: 29.983
Authors: Bjarne Linde Nørgaard; Jonathon Leipsic; Bon-Kwon Koo; Christopher K Zarins; Jesper Møller Jensen; Niels Peter Sand; Charles A Taylor Journal: Curr Cardiovasc Imaging Rep Date: 2016-01-05