Abstract 4361: The Hemodynamic Significance of Non-culprit Coronary Artery Stenoses Can Be Reliably Evaluated With FFR During the Acute Phase of Acute Coronary Syndromes
Objectives: Assessing the hemodynamic severity of the non-culprtit coronary stenoses in patients with acute coronary syndromes could improve risk stratification and prediction of future cardiovascular events and can shorten the diagnostic work-up. We investigated the reliability of fractional flow reserve (FFR) in non-culprit stenoses assessed during the acute phase of a STEMI or NSTEMI.
Methods: Ninety three patients (68 STEMI, 25 NSTEMI) were prospectively recruited. The FFR of 105 non-culprit stenoses was measured immediately after PCI of the culprit, and at follow-up evaluation (mean 38±39 days). Both during the acute phase and at follow-up, a left ventricular (LV) angiogram was performed and QCA, TIMI flow and corrected TIMI frame count (cTFC) of the non-culprits were also assessed.
Results: TIMI flow, cTFC, % diameter stenosis and MLD of the non-culprits did not change. LV ejection fraction was significantly increased only in STEMI group (from 56±14 to 58±13%, p=0.025). There was a no significant change in the FFR of the non-culprits between acute and follow-up phase for both STEMI and NSTEMI (0.77±0.1 vs 0.76±0.1, p=ns for STEMI and 0.77±0.1 vs 0.76±0.1, p=ns for NSTEMI respectively). A lower variability of variance for the FFR as compared with % diameter stenosis and MLD values was also observed (5±6 vs 14±16 vs 20±19% respectively, p=0.0001). In 3 patients, the FFR value was higher than 0.8 at the acute phase and lower than 0.75 at follow-up.
Conclusions: FFR can reliably assess the hemodynamic severity of non-culprit coronary artery stenoses during the acute phase of acute coronary syndromes.