Long-term effects of fractional flow reserve: Guided compared with angiography-guided percutaneous coronary intervention

Objective. Fractional Flow Reserve (FFR) is a pressure derived measure, lesion specific, physiological index for determining hemodynamic severity of intracoronary lesions. Aim of our study was to examine the advantages of FFR-guided percutaneous coronary intervention (PCI) compared to conventional, angiography-guided procedure. Method. The study was retrospective, using data from January 2008 to January 2010. A total of 176 patients were examined using FFR and a total of 276 lesions were measured using a standardized protocol that involves positioning of the pressure sensor, premounted on the coronary wire at the ostium of the main coronary artery and distally to the lesion. The control group included 75 patients, who underwent a conventional angiography. Data was collected after the annual follow-up examination. Major cardiac adverse events were outcomes. Results. Out of 197 patients, 71% percent were treated with PCI. A favorable result of over 0.90 was obtained in 90%, while for 10%, the results ranged from 0.8 to 0.9. In the angiography group (AG) 18.6% of patients had total major adverse coronary events compared to 12% in FFR group. One year mortality was 5% in AG and 1.8% in FFR group. Myocardial infarction was diagnosed in 11% in AG and in 9% in FFR group, and there was a need for repeat PCI in 9.5% in AG and 6.5% in FFR group. Conclusion. Our study showed that the use of FFR reduces total major adverse coronary events.