5-year TVF and MACCE in patients with deferred of revascularization after FFR: Is FFR enough?

Fractional flow reserve (FFR) has been shown effective and safe by different studies, yet not at 5 years. 

Eventos cardiovasculares a 5 años luego de postergar la revascularización guiada por FFR, ¿Debemos guiarnos sólo por el valor obtenido con esta técnica? 

The aim of this multicenter registry was to assess the impact of thrombotic risk (as per CREDO-Kyoto score) as a predictor of cardiovascular events at 5 years in patients with deferred revascularization after FFR measurement. 

The score used in this study was only validated for the Japanese population; it includes variables such as chronic kidney failure, atrial fibrillation, peripheral vascular disease, anemia, age >75, cardiac failure and diabetes. 

Cardiovascular events related to the treated vessel were considered target vessel failure (TVF), and defined as a composite of cardiovascular death, target vessel MI, and clinically driven TVF, while patient related events were considered MACCE (including total death, cerebrovascular events, AMI and revascularization). 

Read also: ACC 2022 | SPYRAL HTN-ON: Is It Time to Start Using Renal Denervation?

They looked at 1263 patients, mean age 70, mostly hypertensive and dyslipidemic. The most frequent clinical presentation was stable angina, and the anterior descending was the most treated vessel. 

At 5 years, patients at high risk, according to this score, showed greater MACE rate, at the expense of all cause death. In addition, this group of patients presented a higher rate of TVF. Patients with positive FFR had a higher incidence of TVF at the expense of clinical guided revascularization at 5 years. 

There were no differences in MACCE between FFR positive and negative patients at 5 years.

Read also: ACC 2022 | FLAVOUR Study: FFR and IVUS in Intermediate Coronary Lesions.

Patients at high risk of thrombosis and negative FFR presented the highest rate of TVF and MACCE. 

Conclusion

Among CAD patients with deferred revascularization after FFR, thrombotic risk and FFR value were associated to MACCE and TVF at 5 years. Patients with high thrombosis risk presented the highest risk, even with negative FFR. 

Dr. Andrés Rodríguez

Dr. Andrés Rodríguez
Member of the Editorial Board in SOLACI.org .

Original Title: Thrombotic Risk and Cardiovascular Events in Patients With Revascularization Deferral After Fractional Flow Reserve Assessment.

Reference: Yasutsugu Shiono, MD, PHD et al J Am Coll Cardiol Intv 2022;15:427–439.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

More articles by this author

TCT 2024 | FAVOR III EUROPA

The study FAVOR III EUROPA, a randomized trial, included 2,000 patients with chronic coronary syndrome, or stabilized acute coronary syndrome, and intermediate lesions. 1,008...

TCT 2024 – ECLIPSE: Randomized Study of Orbital Atherectomy vs Conventional PCI in Severely Calcified Lesions

Coronary calcification is associated with stent under-expansion and increased risk of both early and late adverse events. Atherectomy is an essential tool for uncrossable...

TCT 2024 | Use of Drug-Coated Balloons for Side Branch Treatment in Provisional Stenting

In some cases, treating coronary bifurcations with provisional stenting requires side branch stenting, which may lead to suboptimal outcomes. Drug-coated balloons (DCBs) have emerged...

TCT 2024 | Use of Artificial Intelligence for Patients with Suspected Coronary Artery Disease

The current approach to chest pain mainly focuses on symptom characteristics, conducting functional tests for ischemia assessment. However, several randomized clinical trials have shown...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

TCT 2024 | FAVOR III EUROPA

The study FAVOR III EUROPA, a randomized trial, included 2,000 patients with chronic coronary syndrome, or stabilized acute coronary syndrome, and intermediate lesions. 1,008...

TCT 2024 | TRISCEND II

This randomized study included 400 patients; 267 were treated with EVOQUE valve and 133 with optimal medical treatment (OMT). After one-year follow-up, there were no...

TCT 2024 – ACCESS-TAVI: Comparing Percutaneous Access Closure Strategies After TAVI

Vascular access complications following transcatheter aortic valve implantation (TAVI) remain common. However, few studies compare vascular access closure methods.  Based on the CHOICE-CLOSURE and MASH...