Abstract 11372: Value of Percent Coronary Stenosis to Predict Fractional Flow Reserve (FFR) in Patients with Intermediate Coronary Lesions: Insights From A Large French Multicenter Registry
Background It has previously been shown that fractional flow reserve (FFR) is inversely related to the degree of coronary stenosis. There is however no report of the value of the degree of coronary stenosis as a predictor of FFR respective to other lesion's and patient's characteristics.
Methods and Results The R3F registry investigated the use of FFR in 20 French centers from October 2008 to June 2010. During this period, FFR was measured in 1266 lesions in 945 consecutive patients. 75% of patients were males with a mean age of 65±10 years, 37% were diabetics and 19% had a recent ACS. Patients had non significant (< 50% stenosis) angiographic coronary artery disease (14%), significant (>50%) angiographic 1-vessel (37%), 2-vessel (30%) or 3-vessel disease (19%).
63% of the lesions were located in the LAD, 15% in the LCx and 22% in the RCA. 66% were A/B1 and 34M B2/C in ACC/AHA classification. The mean reference diameter was 2.85 ±0.59mm, the mean lesion length was 12.6 ±7.8, the mean % stenosis was 52±13 and the mean FFR was 0.82±.09.
Univariate and multivariate analyses of the predictors of FFR were performed. The results of the multivariate analysis are presented below.
Other variables in this model are: Center, gender, diabetes, previous MACE, presence of symptoms, clinical stability, proximal lesion, Reference diameter, minimal luminal diameter.
Conclusion: In patients with intermediate coronary lesions, the degree of stenosis is only a weak predictor of FFR. Other lesions characteristics including vessel location, lesion length and lesion complexity are much stronger predictors of FFR. These results are important to understand the mechanisms linking lesion characteristics to myocardial ischemia.
- © 2011 by American Heart Association, Inc.