title: One-year outcome of patients submitted to routine fractional flow reserve assessment to determine the need for angioplasty.
abstract: OBJECTIVE
  In patients submitted to coronary angiography, fractional flow reserve (FFR) assessment by a pressure wire can be used to guide the decision for revascularization. Routine application of FFR assessment and 1-year outcome of patients are poorly documented. The aim of this study was to report a 4-year single-centre experience where the use of FFR for decision making in equivocal lesions is encouraged.
  
  
  RESULTS
  A prospective registry was designed to collect clinical and angiographic characteristics, as well as 1-year clinical follow-up for all patients submitted to FFR assessment. The decisional cut-off point for revascularization was 0.80. Over a 4-year period, out of 6415 coronary angiographies, FFR was measured in 407 (6.3%) patients (469 lesions). FFR was assessed through 4 or 5 Fr diagnostic catheters in 330 (81%). Median FFR value was 0.87 (0.80; 0.93). On the basis of FFR results, 271 (67%) patients were treated with medical therapy alone. A subset of 71 (17%) patients were not treated in accordance with the results of FFR. All patients but four (i.e. 99%) had 1-year clinical follow-up. Three hundred and forty four (85%) were free from clinical event, six (1.5%) patients died, five (4%) had an acute coronary syndrome, and 20 (5%) underwent target-vessel revascularization. Event-free survival was comparable in patients with vs. without revascularization (0.94 +/- 0.02 and 0.93 +/- 0.01, respectively). Patients had significantly better 1-year outcome when treated in accordance with the results of the FFR assessment.
  
  
  CONCLUSIONS
  In routine practice, FFR assessment during diagnostic angiography was performed in 6.3%. On the basis of FFR, two-thirds of patients with 'intermediate' lesions were left unrevascularized, with a favourable outcome, when FFR was above 0.80. These data suggest that routine use of FFR during diagnostic catheterization is feasible, safe, and provide help to guide decision making.
authors.affiliation: Department of Cardiology, EA 3920, University Hospital Jean-Minjoz, Besancon, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Legalery
authors.forename: François
authors.initials: F
authors.lastname: Schiele
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Seronde
authors.forename: Nicolas
authors.initials: N
authors.lastname: Meneveau
authors.forename: Hu
authors.initials: H
authors.lastname: Wei
authors.forename: Katy
authors.initials: K
authors.lastname: Didier
authors.forename: Marie-Cecile
authors.initials: MC
authors.lastname: Blonde
authors.forename: Fiona
authors.initials: F
authors.lastname: Caulfield
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Bassand
mesh_terms: D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology*; D023921:Coronary Stenosis / Q000503:physiopathology / Q000601:surgery*; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000706:statistics & numerical data*; D011379:Prognosis; D011446:Prospective Studies; D012017:Referral and Consultation; D012039:Regional Blood Flow / Q000502:physiology; D016019:Survival Analysis; D013997:Time Factors