Fractional flow reserve (FFR) guidance can help cardiologists make better decisions during percutaneous coronary intervention (PCI)—can it lead to better outcomes for patients with stable angina pectoris? The authors of a new study in the Journal of the American College of Cardiology explored that very question.
The researchers examined data from more than 20,000 patients who underwent PCI for stable angina pectoris in Sweden from January 2005 to March 2016. The study’s primary endpoint was all-cause mortality, and its secondary endpoints were stent thrombosis, restenosis and peri-procedural complications.
Overall, FFR guidance was used during the treatment for 3,357 PCI patients. After a median follow-up period of 4.7 years, the FFR patients had lower risk estimates for all-cause mortality, stent thrombosis and restenosis compared to the patients who underwent angiography-guided PCI. When looking at peri-procedural complications, however, there was no significant difference in the two patient groups.
“Our results support the current guidelines that promote the use of FFR for decision-making during PCI,” wrote lead author Sebastian Völz, MD, PhD, Sahlgrenska University Hospital in Sweden, and colleagues.
The authors also addressed the continued inconsistency they see when it comes to FFR utilization, saying the gaps are often due to specialists who don’t want to change their techniques, a general lack of familiarity with FFR or a belief that FFR should not be recommended.
“Considering the growing evidence of benefit, more extensive implementation of FFR should have a high priority for improving long-term clinical outcomes in patients with ischemic heart disease,” Völz et al. wrote. “The importance of this clinical goal is supported by the fact that survival in patients with stable angina pectoris after PCI in Sweden has improved in recent years in parallel with the substantial increase in the use of pressure wire measurements. Recent progress in technology has allowed the development of noninvasive physiological assessment tools of coronary artery disease such as computed tomography FFR and myocardial perfusion cardiovascular magnetic resonance imaging.”
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.