title: Fractional flow reserve-guided management in stable coronary disease and acute myocardial infarction: recent developments.
abstract: Coronary artery disease (CAD) is a leading global cause of morbidity and mortality, and improvements in the diagnosis and treatment of CAD can reduce the health and economic burden of this condition. Fractional flow reserve (FFR) is an evidence-based diagnostic test of the physiological significance of a coronary artery stenosis. Fractional flow reserve is a pressure-derived index of the maximal achievable myocardial blood flow in the presence of an epicardial coronary stenosis as a ratio to maximum achievable flow if that artery were normal. When compared with standard angiography-guided management, FFR disclosure is impactful on the decision for revascularization and clinical outcomes. In this article, we review recent developments with FFR in patients with stable CAD and recent myocardial infarction. Specifically, we review novel developments in our understanding of CAD pathophysiology, diagnostic applications, prognostic studies, clinical trials, and clinical guidelines.
authors.affiliation: West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK colin.berry@glasgow.ac.uk.
authors.forename: Colin
authors.initials: C
authors.lastname: Berry
authors.affiliation: West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK.
authors.forename: David
authors.initials: D
authors.lastname: Corcoran
authors.affiliation: West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK.
authors.forename: Barry
authors.initials: B
authors.lastname: Hennigan
authors.affiliation: West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK.
authors.forename: Stuart
authors.initials: S
authors.lastname: Watkins
authors.affiliation: St Vincent's Hospital, Melbourne, Australia.
authors.forename: Jamie
authors.initials: J
authors.lastname: Layland
authors.affiliation: West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK.
authors.forename: Keith G
authors.initials: KG
authors.lastname: Oldroyd
mesh_terms: D054058:Acute Coronary Syndrome / Q000503:physiopathology / Q000628:therapy; D000241:Adenosine / Q000008:administration & dosage / Q000494:pharmacology; D000367:Age Factors; D001795:Blood Pressure Determination / Q000379:methods; D057791:Cardiac Imaging Techniques / Q000379:methods; D002496:Central Venous Pressure / Q000502:physiology; D003327:Coronary Disease / Q000503:physiopathology / Q000628:therapy*; D023921:Coronary Stenosis / Q000503:physiopathology / Q000628:therapy; D005544:Forecasting; D053805:Fractional Flow Reserve, Myocardial / Q000502:physiology*; D006801:Humans; D007262:Infusions, Intravenous; D015337:Multicenter Studies as Topic; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D012737:Sex Factors; D014655:Vascular Resistance / Q000502:physiology; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000494:pharmacology
chemical_list: D014665:Vasodilator Agents; D000241:Adenosine
keywords: Coronary revascularization; Fractional flow reserve; Medical therapy; Myocardial infarction; Stable angina