Original Title: Impact of routine Fractional Flow Reserve on management decision and 1-year clinical outcome of ACS patients: Insights from the POST-IT and R3F Integrated Multicenter registriEs –Implementation of FFR in Routine Practice (PRIME-FFR).
Presenter: Luís Raposo.
Supported by a large body of evidence, the use of fractional flow reserve (FFR) has clearly been established for stable chronic angina patients, but not for ACS patients.
For this study, researchers used data from two multicenter prospective registries (R3F and POST-IT) with more than 2000 patients, one third of them admitted with ongoing ACS.
The routine use of FFR in patients with unstable angina / non ST elevation MI, is associated to a high rate of treatment strategy reclassification, since after FFR, more patients are prescribed revascularization (either percutaneous or surgical).
In patients undergoing ACS, the original medical treatment strategy by conventional angiogram, has been reduced from 56.7% to 48.9% after FFR. The PCI group has grown from 35.3% (before FFR) to 41.5%, something similar has happened to surgery, going from 6% to 9.6%.
Conclusion
Using FFR in decision making for patients undergoing acute coronary syndromes has often changed the original strategy that would have been applied using only conventional angiogram. In addition, it has resulted as safe as in stable patients. Large randomized studies should be carried out to confirm the use of FFR in the acute clinical context.
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