title: Modification of treatment strategy after FFR measurement: CVIT-DEFER registry.
abstract: The impact of the fractional flow reserve (FFR) on clinical decision-making remains unclear in daily practice. The CVIT-DEFER registry is a prospective multicenter registry enrolling consecutive patients with angiographically intermediate coronary stenosis for whom FFR measurement is clinically indicated. The treatment strategy determined from angiographic findings alone and the strategy selected after FFR measurement were compared. Data on the treatment strategy were obtained for 3093 subjects. The average age of these subjects was 69.5 ± 10.2 years and 73.8 % were men. The majority had stable coronary artery disease, including 60.4 % with stable angina pectoris. The treatment strategy based on angiographic findings was medical management in 34.5 %, percutaneous coronary intervention (PCI) in 63.5 %, and coronary artery bypass grafting in 2.1 %. The FFR was ≤0.8 in 1566 lesions (42.2 %). After FFR measurement, medical treatment was changed to revascularization in 19.7 %, while PCI was switched to medical treatment in 57.4 % at the lesion level. As a result, reclassification of the treatment strategy at the patient level was done in 39.0 % of the patients. Revascularization was frequently switched to medical treatment after FFR measurement. These findings support the clinical utility of employing FFR data to guide selection of PCI.
authors.affiliation: Division of Cardiovascular Medicine, Ohashi Medical Center, Toho University School of Medicine, 2-17-6 Ohashi, Meguro-ku, Tokyo, 153-8515, Japan, masato@oha.toho-u.ac.jp.
authors.forename: Masato
authors.initials: M
authors.lastname: Nakamura
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamagishi
authors.forename: Takafumi
authors.initials: T
authors.lastname: Ueno
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hara
authors.forename: Sugao
authors.initials: S
authors.lastname: Ishiwata
authors.forename: Tomonori
authors.initials: T
authors.lastname: Itoh
authors.forename: Ichiro
authors.initials: I
authors.lastname: Hamanaka
authors.forename: Tetsuzo
authors.initials: T
authors.lastname: Wakatsuki
authors.forename: Teruyasu
authors.initials: T
authors.lastname: Sugano
authors.forename: Kazuya
authors.initials: K
authors.lastname: Kawai
authors.forename: Takashi
authors.initials: T
authors.lastname: Akasaka
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tanaka
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kimura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D003657:Decision Making; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D016896:Treatment Outcome