Usefulness of fractional flow reserve in multivessel coronary artery disease with intermediate lesions.
BACKGROUND
Calculation of myocardial fractional flow reserve (FFR) enables coronary stenoses to be evaluated.


OBJECTIVE
We determined the usefulness of measuring the FFR in multivessel coronary artery disease, reflected in changes in the therapeutic options for patients with moderate coronary stenosis.


METHODS
We studied 38 patients (30 men, 8 women; mean age: 59.8+/-10 years) with multivessel coronary artery disease with 41 moderate lesions. Indications for coronary angiography were unstable angina in 24 patients (60%), acute myocardial infarction in 10 (27%), and stable angina in 4 (13%). We studied the FFR (in nonactive lesions) in the left anterior descending artery in 23 patients (56%), the left coronary trunk in 8 (19.5%), the circumflex artery in 5 (12.2%), the right coronary artery in 3 (7.3%), and the left internal mammary artery and diagonal branch in 1 patient each.


RESULTS
Twelve patients had a positive FFR, which resulted in no change in the mode of revascularization; 26 patients had a negative FFR, in 20 (77%) of whom the revascularization approach was changed, especially those with moderate lesions of the left coronary trunk or anterior descending artery. No differences were detected in the angiographic characteristics of the lesions examined. Cardiac events during follow-up were few.


CONCLUSIONS
The results of FFR may influence the decision-making process after diagnostic coronary angiography in multivessel coronary artery disease with moderate lesions, especially in patients with a negative FFR in nonculprit lesions of the left trunk or left anterior descending artery.
Jiménez-Navarro
Manuel F
MF
Hospital Clínico Universitario Virgen de la Victoria de Málaga, Spain. jimeneznavarro@secardiologia.es
Alonso-Briales
Juan
J
Hernández-García
José María
JM
Curiel
Emilio
E
Kühlmorgen
Birgit
B
Gómez-Doblas
Juan José
JJ
García-Pinilla
José Manuel
JM
Robledo
Juan
J
De Teresa
Eduardo
E
D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D003331:Coronary Vessels / Q000502:physiology*; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index