Fractional flow reserve (FFR) has been shown effective and safe by different studies, yet not at 5 years. 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…
ESC 2021 | RIPCORD-2: Routine FFR Evaluation of All Epicardial Vessels During Angiography
The predecessor of this research—RIPCORD, published in 2014—showed that using fractional flow reserve (FFR) changes the treatment strategy in about 25% of patients. That marked the rise of FFR. In fact, the DEFER, FAME, and FAME 2 studies offered results consistent with the original RIPCORD. In this research, authors tested the hypothesis of systematic use of…
FLOWER-MI: FFR vs. Angiography for Complete Revascularization in Infarction
Functional assessment with fractional flow reserve (FFR) was not better than conventional angiography to guide complete revascularization in patients with multivessel lesions in a setting of ST-segment elevation myocardial infarction and successful primary angioplasty. These results were published in the New England Journal of Medicine (NEJM) and presented during the American College of Cardiology (ACC)…
Impact of FFR After Stenting: Useful or Mere Fun Fact?
Suboptimal fractional flow reserve (FFR) results after stenting only have a moderate impact on clinical hard points but might predict a much higher risk of reintervention. FFR has shown a huge impact on the decision-making process when it comes to revascularizing (or not) a lesion. Its impact after angioplasty has not been fully studied, particularly…
Global FFR as Prognosis in CAD Patients without Ischemia
Global fractional flow reserve (FFR) results from adding up FFR values of the three major coronary arteries. This figure represents the physiological atherosclerosis burden and can predict events at long term in patients without stenosis leading to ischemia. This recent study published in JAHA looked at major cardiovascular events (death, infarction and revascularization) at 5…
AHA 2020 | The More Operators “Listen” to FFR, the Lower the Risk
When operators decide to proceed with PCI despite a negative FFR (fairly frequent in the daily practice) outcomes at 5 years are far worse. This information comes from a large Canadian register presented at AHA 2020 Scientific Sessions, simultaneously published in JAMA. PCI to a non-ischemic lesion results in increased events risk at long term,…
TCT 2020 | New Information about Pre and Post PCI FFR Value
The TARGET FFR and DEFINE-FLOW studies were presented at TCT 2020 which have offer a deeper perspective on the value of FFR, not only before but also after PCI. TARGET FFR The TARGET FFR included 260 patients randomized after angiographically successful PCI to an FFR guided optimization vs. blinded FFR assessment strategies. In the guided…
Compare-Acute Sub-Study: Natural History of Non-Culprit Lesions in MI
The aim of this study was to determine the prognostic value of fractional flow reserve (FFR) of non-culprit lesions in STEMI patients. We analyzed data of all Compare-Acute patients (Comparison Between FFR Guided Revascularization Versus Conventional Strategy in Acute STEMI Patients With MVD) after PCI, from lesions assessed with FFR and treated medically. The treating…
iFR or FFR Measurements by Sex: Is Either One More Adequate?
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,…
TCT 2019 | FORZA: OCT vs FFR to Define Intermediate Lesions: Anatomy or Function?
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,…