Korean Circ J.  2008 Sep;38(9):468-474. 10.4070/kcj.2008.38.9.468.

Assessment of Intermediate Coronary Stenosis in Koreans Using the Fractional Flow Reserve

• Park KH
• Koo BK
• Suh JW
• Lee HY
• Park JS
• Kang HJ
• Cho YS
• Chung WY
• Youn TJ
• Chae IH
• Choi DJ
• Kim HS
• Oh BH
• Park YB

• KMID: 1776347
• DOI: http://doi.org/10.4070/kcj.2008.38.9.468

Abstract

BACKGROUND AND OBJECTIVES
Previous studies that used physiologic parameters have shown that coronary angiography is not always accurate in the evaluation of intermediate lesions. We sought to evaluate the outcomes of Korean patients for whom revascularization was deferred according to their fractional flow reserve (FFR). SUBJECTS AND METHODS: FFR was measured in 107 intermediate lesions (visually estimated percent stenosis: 40-70%) in 102 consecutive patients (68% males, mean age: 62+/-9 years). The one-year cardiac adverse outcomes (cardiac death, myocardial infarction or target vessel revascularization) of all the patients and the long-term outcomes of the patients for whom revascularization was deferred according to the FFR were evaluated. RESULTS: The mean percent diameter stenosis was 57+/-11% and the FFR was 0.82+/-0.10. Only 25 lesions (23%) had a FFR <0.75. There was no significant difference in the 1-year cardiac event rates between the FFR > or =0.75 group and the FFR <0.75 group (10.4% vs. 13.0%, respectively, p=0.49). There was a tendency of a lower incidence of 1-year cardiac events in the medical treatment group than in the revascularizaton group (8.0% vs. 20.0%, respectively, p=0.10). In the 69 patients with FFR-guided deferral of revascularization, the long-term (mean follow-up duration: 41+/-11 months) cardiac event-free survival rate was 86%. CONCLUSION: The measurement of FFR seems to be a useful guide for decision making and it may reduce unnecessary intervention in Korean patients who suffer with intermediate stenosis.

Keyword

Coronary stenosis; Fractional flow reserve, myocardial; Stents

MeSH Terms

Constriction, Pathologic
Coronary Angiography
Coronary Stenosis
Decision Making
Disease-Free Survival
Follow-Up Studies
Fractional Flow Reserve, Myocardial
Glycosaminoglycans
Humans
Incidence
Male
Myocardial Infarction
Stents
Glycosaminoglycans

Figure

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  Fig. 1. Distribution of percent diameter stenosis in 2 groups. FFR: fractional flow reserve, black box: mean value (with standard deviation).

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  Fig. 2. Flow chart of the study population. FFR: fractional flow reserve.

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  Fig. 3. Kaplan-Meier cardiac events-free survival curve of patients in whom revascularization was deferred by fractional flow reserve. Cardiac events: the composite of cardiac death, myocardial infarction or target vessel revascularization.

Reference

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