FLAVOUR was a prospective randomized non-inferiority study in patients with intermediate coronary lesions (40%-70%) that compared two imaging modalities: IVUS (intravascular imaging) and FFR (fractional flow reserve).
According to this research—presented at ACC 2022—, FFR-guided angioplasty was non-inferior to IVUS-guided angioplasty at 2 years of follow-up. Furthermore, using FFR-based imaging led to fewer stent implantations.
A total of 1682 patients with intermediate coronary lesions were enrolled and divided into two groups: 838 were assigned to the FFR group, and 844 to the IVUS group.
The indication for coronary angioplasty included an FFR ≤0.80 and, for the IVUS group, a minimal luminal area ≤3 mm2 or a minimal luminal area >3 mm2 but ≤4 mm2 plus a plaque border >70%.
In the FFR group, only 44.4% of patients underwent coronary angioplasty compared with 65.3% in the IVUS group (p < 0.001).
The primary endpoint (PEP) was a composite of all-cause mortality, myocardial infarction, and any revascularization at 24 months. In that sense, the PEP occurred in 8.6% vs 8.1% for IVUS and FFR, respectively (pnon-inferiority = 0.015; margin of non-inferiority: 2.5%).
Read also: ACC 2022 | CLASP TR Study: Tricuspid Valve Repair with the PASCAL Device.
Furthermore, there were no differences regarding events analyzed separately between the two groups, nor was the presence of angina observed in the Seattle Angina Questionnaire scores.
There was a lower tendency towards stenting in the FFR group.
There was also no difference between groups in patients who received medical treatment.
Dr. Carlos Fava.
Member of the editorial board in SOLACI.org .
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