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Abstract
Background and Objectives
Previous studies that used physiologic parameters have shown that coronary angiography is not always accurate in the evaluation of intermediate lesions. We sought to evaluate the outcomes of Korean patients for whom revascularization was deferred according to their fractional flow reserve (FFR).
Subjects and Methods
FFR was measured in 107 intermediate lesions (visually estimated percent stenosis: 40–70%) in 102 consecutive patients (68% males, mean age: 62±9 years). The one-year cardiac adverse outcomes (cardiac death, myocardial infarction or target vessel revascularization) of all the patients and the long-term outcomes of the patients for whom revascularization was deferred according to the FFR were evaluated.
Results
The mean percent diameter stenosis was 57±11% and the FFR was 0.82±0.10. Only 25 lesions (23%) had a FFR <0.75. There was no significant difference in the 1-year cardiac event rates between the FFR ≥0.75 group and the FFR <0.75 group (10.4% vs. 13.0%, respectively, p=0.49). There was a tendency of a lower incidence of 1-year cardiac events in the medical treatment group than in the revascularizaton group (8.0% vs. 20.0%, respectively, p=0.10). In the 69 patients with FFR-guided deferral of revascularization, the long-term (mean follow-up duration: 41±11 months) cardiac event-free survival rate was 86%.
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Fig. 1.
Distribution of percent diameter stenosis in 2 groups. FFR: fractional flow reserve, black box: mean value (with standard deviation).
Fig. 3.
Kaplan-Meier cardiac events-free survival curve of patients in whom revascularization was deferred by fractional flow reserve. Cardiac events: the composite of cardiac death, myocardial infarction or target vessel revascularization.
Table 1.
Baseline characteristics of patients (n=102)
Table 2.
Baseline characteristics of lesions
Table 3.
One-year adverse cardiac events
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