Backgrounds: Fractional flow reserve (FFR) is the gold standard invasive method to detect the ischemia-causing coronary stenosis. FFR-guided revascularization strategy is reported to be better than angiography-guided revascularization strategy. However, all these evidences are based on data from Western population. We performed this study to assess the long-term clinical outcomes of this strategy in Korean patients.
Methods: From Mar, 2004 till Mar, 2011, 1991 consecutive patients who underwent FFR measurement were enrolled from 4 Korean hospitals. After exclusion of in-stent restenosis, bypass surgery, side branch measurement and post-intervention measurement alone, 1629 patients were included in this study (Up to now, the data of 1358 patients (62짹10 yrs, male 67%, multi-vessel disease 54%, diabetes 29%) were analyzed. Final results will be presented at the meeting.). All data and angiograms were collected and analyzed in an independent core laboratory. Major cardiac adverse events were defined as cardiac death, target vessel myocardial infarction (MI) and target lesion revascularization (TLR). All deaths without definite cause were regarded as cardiac deaths. Each MACE was separately counted as stent-related, deferred-lesions related and new-lesion related events.
Results: FFR was measured in 1787 vessels (LAD 1124, 68%) and mean FFR was 0.81짹0.14 and FFR was < 0.8 in 716 vessels (40.1%). Mean and median follow-up duration were 735 and 629 days and follow-up was lost in 14 patients (1.0%). In lesions with FFR<0.8, revascularization was performed in 79.2% (567/716) and in lesions with FFR���0.8, revascularization was deferred in 74.1% (794/1071). During follow-up, TLR in lesions with FFR-guided deferral occurred in 31 vessels, including 1 MI due to a deferred lesion. Stent implantation was performed in 844 vessels during index procedures and stent-related TLR and MI occurred in 58 and 2 vessels, respectively. There were 35 events due to newly-developed lesions in non-FFRed and non-stented vesseles. There were 16 cardiac deaths. Among them 4 patients had only deferred lesions, 9 patients, stented lesions and 3 patients, both deferred and stented lesions.
Conclusion: The event rate of FFR-guided deferred lesion was relatively low. FFR-guided revascularization seems to be safe and effective strategy in Korean patients.