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PCI Using Fractional Flow Reserve Effective at Two Years

In CAD patients, reduces mortality, myocardial infarction compared with angiography-guided PCI

THURSDAY, May 27 (HealthDay News) -- The use of percutaneous coronary intervention (PCI) guided by fractional flow reserve (FFR) in patients with multivessel coronary artery disease (CAD) significantly reduces mortality and myocardial infarction at two years compared with standard angiography-guided PCI, according to a study published online May 26 in the Journal of the American College of Cardiology.

Nico H.J. Pijls, M.D., of Catharina Hospital in Eindhoven, Netherlands, and colleagues randomized 1,005 patients with multivessel CAD to PCI with drug-eluting stents guided by angiography alone or guided by FFR measurements. They previously found that routine FFR plus angiography improved PCI outcomes after one year of follow-up.

In the current study, the researchers found that the two-year rates of mortality or myocardial infarction were lower in the FFR-guided group compared to the angiography-guided group (8.4 versus 12.9 percent; P = 0.02). Rates of PCI or coronary artery bypass surgery were also lower in the FFR-guided group compared to the angiography-guided group (10.6 versus 12.7 percent; P = 0.30). In addition, the combined rates of death, nonfatal myocardial infarction, and revascularization were 17.9 percent in the FFR-guided group and 22.4 percent in the angiography-guided group (P = 0.08).

"The FAME study showed that in patients with multivessel CAD, favorable outcome after routine measurement of FFR during PCI as compared with the standard strategy of PCI guided by angiography alone is maintained at two-year follow-up," the authors write.

Two authors disclosed financial ties to St. Jude Medical and one to Biosensors and Boston Scientific.

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