FRACTIONAL FLOW RESERVE: AN EXPERIENCE OF 100 PATIENTS AT AFIC-NIHD

Abstract

Objective: To evaluate the importance of Fractional Flow Reserve (FFR) in
decision making in coronary revascularization in moderate lesions.
Methodology: A retrospective descriptive study was conducted at Armed Forces
Institute of Cardiology (AFIC) /National Institute of Heart Diseases (NIHD) from
June 2008 to December 2012.A total of 100 consecutive patients who underwent
FFR were assessed. These were the cases in which decision regarding
percutaneous coronary intervention (PCI) was difficult on visual assessment
alone. A 0.014” FFR wire was used and pressure gradients across the lesions
were noted. Post procedural follow up was done at six months telephonically for
symptoms of angina and heart failure and further treatment was planned
accordingly.
Results: A total of 100 patients whose coronary artery lesions were assessed by
FFR were analyzed. The mean age was 54.5±8.9 years. Male patients were 89
(89%). The mean FFR score obtained was 0.84. In 25% of patients (n= 25) the
coronary stenosis was found to be clinical significant (FFR < 0.80) and in 75% of
the patients (n=75) the coronary stenosis was not significant (FFR > 0.80).
Based on the above results revascularization was done in 25 patients (21 PCI with
stenting and 4 with coronary artery bypass graft surgery). Medical treatment was
advised in 75 patients with FFR > 0.80. Only one patient in the >0.80 FFR group
required stenting during follow up because of progression of disease and the rest
were stable on medical treatment.
Conclusion: FFR is important tool in guiding PCI in moderate lesions.