TY - JOUR
T1 - Prognostic impact of FFR/contrast FFR discordance
AU - Leone, Antonio Maria
AU - Arioti, Manfredi
AU - Cialdella, Pio
AU - Vergallo, Rocco
AU - Zimbardo, Giuseppe
AU - Migliaro, Stefano
AU - Anastasia, Gianluca
AU - Di Giusto, Federico
AU - Galante, Domenico
AU - Basile, Enrico
AU - Pepe, Francesca Lassandro
AU - Ierardi, Carolina
AU - D'Amario, Domenico
AU - Burzotta, Francesco
AU - Aurigemma, Cristina
AU - Niccoli, Giampaolo
AU - Trani, Carlo
AU - Crea, Filippo
PY - 2020
Y1 - 2020
N2 - Background: Contrast fractional flow reserve (cFFR) is a relatively new tool for the assessment of intermediate coronary artery stenosis and represents a reliable surrogate of FFR with the advantage of potentially simplifying functional evaluation. We aimed to compare the incidence of major adverse cardiac events (MACE) in patients undergoing functional evaluation with both FFR and cFFR based on the results of the two indexes. Method and Result: We retrospectively analyzed outcomes in 488 patients who underwent functional evaluation with FFR and cFFR. Patients were divided into four groups using the cutoff values of 0.80 for FFR and 0.85 for cFFR: −/− (n = 298), +/+ (n = 134), −/+(n = 31) and +/− (n = 25). All patients were treated according to FFR value. MACE rate was assessed in each group, including death, myocardial infarction and urgent target vessel revascularization (TVR). Mean follow-up time was 22 ± 15 months. Incidence of MACE at follow-up was 8.3% in FFR−/cFFR−, 14.0% in FFR+/cFFR+, 16.0% in FFR−/cFFR+ and 8.0% in FFR+/cFFR− without a significant difference amongst the 4 groups (p = 0.2). Nevertheless, a significant difference in the rate of TVR comparing FFR−/cFFR− (n = 17) and FFR−/cFFR+ (n = 5) was found at 24 months (5.7% vs 16.0%; p = 0.027). Conclusion: cFFR is accurate in predicting FFR and consequently reliable in guiding coronary revascularization. In the rare case of discordance, while FFR+/cFFR- patients show a prognosis similar to FFR-/cFFR- patients, FFR-/cFFR+ patients show a prognosis similar to FFR+/cFFR+ patients.
AB - Background: Contrast fractional flow reserve (cFFR) is a relatively new tool for the assessment of intermediate coronary artery stenosis and represents a reliable surrogate of FFR with the advantage of potentially simplifying functional evaluation. We aimed to compare the incidence of major adverse cardiac events (MACE) in patients undergoing functional evaluation with both FFR and cFFR based on the results of the two indexes. Method and Result: We retrospectively analyzed outcomes in 488 patients who underwent functional evaluation with FFR and cFFR. Patients were divided into four groups using the cutoff values of 0.80 for FFR and 0.85 for cFFR: −/− (n = 298), +/+ (n = 134), −/+(n = 31) and +/− (n = 25). All patients were treated according to FFR value. MACE rate was assessed in each group, including death, myocardial infarction and urgent target vessel revascularization (TVR). Mean follow-up time was 22 ± 15 months. Incidence of MACE at follow-up was 8.3% in FFR−/cFFR−, 14.0% in FFR+/cFFR+, 16.0% in FFR−/cFFR+ and 8.0% in FFR+/cFFR− without a significant difference amongst the 4 groups (p = 0.2). Nevertheless, a significant difference in the rate of TVR comparing FFR−/cFFR− (n = 17) and FFR−/cFFR+ (n = 5) was found at 24 months (5.7% vs 16.0%; p = 0.027). Conclusion: cFFR is accurate in predicting FFR and consequently reliable in guiding coronary revascularization. In the rare case of discordance, while FFR+/cFFR- patients show a prognosis similar to FFR-/cFFR- patients, FFR-/cFFR+ patients show a prognosis similar to FFR+/cFFR+ patients.
KW - Contrast
KW - Fractional flow reserve
KW - Percutaneous coronary intervention
KW - Personalized medicine
KW - Physiological evaluation
KW - Contrast
KW - Fractional flow reserve
KW - Percutaneous coronary intervention
KW - Personalized medicine
KW - Physiological evaluation
UR - http://hdl.handle.net/10807/167726
U2 - 10.1016/j.ijcard.2020.11.011
DO - 10.1016/j.ijcard.2020.11.011
M3 - Article
SN - 0167-5273
SP - 34085
EP - 34087
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -