Version 1
: Received: 27 August 2024 / Approved: 28 August 2024 / Online: 28 August 2024 (13:40:49 CEST)
How to cite:
Grib, A.; Abras, M.; Surev, A.; Grib, L. Fractional Flow Reserve Implications for Clinical Decision Making in Coronary Artery Disease. Preprints2024, 2024082033. https://doi.org/10.20944/preprints202408.2033.v1
Grib, A.; Abras, M.; Surev, A.; Grib, L. Fractional Flow Reserve Implications for Clinical Decision Making in Coronary Artery Disease. Preprints 2024, 2024082033. https://doi.org/10.20944/preprints202408.2033.v1
Grib, A.; Abras, M.; Surev, A.; Grib, L. Fractional Flow Reserve Implications for Clinical Decision Making in Coronary Artery Disease. Preprints2024, 2024082033. https://doi.org/10.20944/preprints202408.2033.v1
APA Style
Grib, A., Abras, M., Surev, A., & Grib, L. (2024). Fractional Flow Reserve Implications for Clinical Decision Making in Coronary Artery Disease. Preprints. https://doi.org/10.20944/preprints202408.2033.v1
Chicago/Turabian Style
Grib, A., Artiom Surev and Livi Grib. 2024 "Fractional Flow Reserve Implications for Clinical Decision Making in Coronary Artery Disease" Preprints. https://doi.org/10.20944/preprints202408.2033.v1
Abstract
Fractional flow reserve (FFR) is regarded as the gold standard for assessing the functional significance of coronary artery lesions, yet it remains underutilized in clinical practice. Our objective was to investigate whether FFR results have the potential to alter treatment decisions for coronary lesions compared to visual assessments of angiographic images made by three operators at a high-volume interventional center. In this retrospective study, we aimed to reassess the angiographic images of 63 patients presenting with chronic coronary syndrome (n=39, 61.9%) and acute coronary syndrome (n=24, 38.1%) who underwent FFR. Three experienced interventional cardiologists (with >300 PCI procedures per year) reevaluated, blinded to FFR results, 105 ambiguous lesions in 63 patients to determine angiographic significance and treatment strategy. The observers reached a concordant agreement (≥2 operators made the same decision) to perform PCI in 60 (57.1%) of the lesions based on angiographic evaluation. Interestingly, 9 (15%) of these lesions were functionally non-significant (FFR >0.80). The observers agreed to defer PCI in 45 (42.9%) of the lesions; however, 4 (8.9%) of these were functionally significant (FFR ≤0.80) and required PCI. Thus, inter-observer concordance in visual-guided therapeutic decision-making is variable and not always confirmed by the functional significance of coronary lesions.
Medicine and Pharmacology, Cardiac and Cardiovascular Systems
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
