Abstract 4565: Long-term Outcomes of Intermediate Coronary Disease After PCI: Fractional Flow Reserve Guided vs. Intravascular Ultrasound Guided
Backgrounds: Even though intravascular ultrasound (IVUS) provides 3-D anatomic image of coronary artery, it might overestimate real functional significance of the coronary lesion during percutaneous coronary intervention (PCI). FFR-guided PCI strategy was reported to be safe and effective. The aim of this study is to evaluate the safety and efficacy of FFR-guided PCI strategy compared to IVUS guided PCI for intermediate coronary disease.
Methods: Two hundred four patients (102 patients of FFR guided, 102 of FFR), who had intermediate coronary disease (percent diameter stenosis between 70% and 50%), were consecutively included from Nov. 2006 to June 2008. Cut-off value of FFR in FFR guide PCI was 0.75 and cut-off value of minimal lumen area in IVUS guided PCI was 4.0mm2. All patients were divided to FFR guided and IVUS guided group. Major adverse outcomes (death, myocardial infarction and target vessel revascularization (TVR)) were assessed at 12 months after the procedure.
Results: Mean pre-interventional diameter stenosis was smaller in FFR guided group than IVUS guided group (62±7% vs. 68±5%, p<0.001). IVUS guided group had more underwent revascularization therapy (91.2% vs. 41.2%, p<0.001), also had more implanted stent number than FFR guided group (1.3±0.8 vs. 0.8±1.2, p=0.012). One year clinical follow-up was available in 100%. No difference was found in 12-month MACE rates between 2 groups (Table⇓). By multivariate analysis, performing intervention was affected by guided device (FFR vs IVUS, p<0.001, OR 0.09, CI 0.03–0.32), pre-interventional diameter stenosis (p<0.001, OR 1.34, 1.24–1.50).
Conclusions: FFR-guided PCI strategy for intermediate coronary disease resulted in good long-term outcomes as IVUS guided PCI. However, FFR-guided strategy reduced the need for PCI.