Abstract 15472: Impact of the Use of Fractional Flow Reserve (FFR) on the Coronary Revascularization Strategy : Insights from a Large French Multicenter FFR Registry (R3F)
Background: Recent data suggest that fractional flow reserve (FFR) is useful in guiding coronary revascularization. There is however currently no large report of its impact on the decision of coronary revascularization on an individual patient basis.
Methods: The R3F registry investigated the use of FFR in 20 French centers from October 2008 to June 2010. To investigate this issue the investigators were asked to define prospectively their revascularization strategy “a priori” before performing the FFR. This was compared to the final strategy applied to the patient after performing the FFR. The results of the first 945 consecutive patients are presented.
Results: 75% of patients were males with a mean age of 65±10 years, 37% were diabetics and 19% had a recent ACS. Patients had nonsignificant (<50% stenosis) angiographic coronary artery disease (14%), significant (>50%) angiographic 1-vessel (37%), 2-vessel (30%) or 3-vessel disease (19%). The strategy defined “a-priori” by the investigators was medical therapy in 52% and coronary revascularization in 48% (PCI in 37% and CABG in 11%). After the results of FFR the final strategy applied to the patient was medical therapy in 58% and coronary revascularization in 42% (PCI in 31% and CABG in 11%). In individual patients the strategy defined “a priori” was modified by the results of the FFR in 45% of the cases: 1) In 36% of the patients in which medical therapy was the strategy “a priori”, it was modified for PCI (26%) or CABG (10%); 2) In 58% of the patients in which a PCI was the strategy “a priori”, it was modified for medical therapy (50%) or CABG (8%); 3) In 68% of the patients in which a CABG was the strategy “a priori”, it was modified for medical therapy (64%) or PCI (4%).
Conclusion: The present report, based on a large French multicenter registry, demonstrated that although FFR had little impact on the overall rate of revascularization in patients referred for coronary angiography, it modified the individual decision in about 1 out of 2 patients. This data provides addtional support to the concept of “FFR guided revascularization” as an impotant tool to tailor the revascularization strategy in patients with CAD.
- © 2010 by American Heart Association, Inc.