Diabetes does not seem to alter the results of a fractional flow reserve (FFR) measurement in a given lesion. Recently, expert opinions and small studies had questioned the reliability of FFR in this specific patient subgroup. This new observational study soon to be published in JAMA vanquishes all doubts and confirms the efficacy of this...
The results of this great multicenter “real-life” registry are similar to those of randomized clinical trials that studied fractional flow reserve (FFR). Lesion deferral based on FFR is a very safe strategy, even for lesions located in the proximal anterior descending artery. Randomized controlled studies FAME and DEFER convincingly showed the safety of lesion revascularization...
According to the post hoc analysis of the DEFINE-FLAIR, patient sex seems to affect instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR) guided revascularization outcomes. Even though this is not specified in the study protocols, it might affect the gold standard for functional lesion assessment. However, clinical outcomes are similar with both strategies. Therefore,...
In the next days, Dr. Seung Hun and colleagues will publish in J Am Coll Cardiol Intv 2019 a study that answers the title question and also brings peace of mind about the decisions we make based on one of these measurements or the other. This study assessed the physiologic characteristics of discordant lesions between...
Courtesy of SBHCI. Both fractional flow reserve (FFR) and optimal coherence tomography (OCT) can be useful to help define intermediate coronary lesions and optimize PCI outcomes. The FORZA study presented at San Francisco TCT 2019 scientific sessions simultaneously published in JACC randomized patients with intermediate lesions 1:1 to FFR vs OCT. For the FFR arm,...
Coronary artery bypass graft (CABG) anastomosed to one vessel with normal or nearly normal fractional flow reserve (FFR) have poorer graft patency at one year compared against anastomosed grafts to vessels with functionally significant lesions shown by FFR. However, the recent study FARGO (Fractional Flow Reserve Versus Angiography Randomization for Graft Optimization) did not show...
Angiography-derived fractional flow reserve (FFR) demonstrated substantial usefulness, especially in patients with three-vessel lesions. The functional SYNTAX score derived from angiography has the potential to redefine prognosis and treatment strategies compared with the classic anatomical SYNTAX score. This study sought to investigate the applicability of this method in patients with multivessel lesions included in the...
iFR is a safe alternative for lesion deferral even when it comes to the left anterior descending artery (LAD). What is more, patients deferred with iFR showed significantly fewer events than patients deferred using FFR. Neither clinical cardiologists nor interventionists feel comfortable deferring LAD treatment, because it is often perceived as high risk. If functional...
In this large international multicenter population, computed-tomography (CT)-derived fractional flow reserve (FFR) modified treatment recommendation in two-thirds of subjects compared with CT angiography alone, and it was associated with less negative invasive angiographies. It also predicted revascularization and identified low-risk patients. A non-invasive means to know the anatomy and function of patients with stable chronic...
Overall, deferral of lesion revascularization is equally safe with both fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR), with a low rate of events of about 4%. Lesions were more frequently deferred when iFR (as opposed to FFR) was used for functional assessment. Among patients with deferred lesions, acute patients experienced significantly more events...