title: Long-term outcome of FFR-guided PCI for stable coronary artery disease in daily clinical practice: a propensity score-matched landmark analysis.
abstract: OBJECTIVE
  Our aim was to investigate the strength of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) for stable coronary artery disease (CAD) in daily practice.
  
  
  RESULTS
  For this study, 3,512 patients with stable CAD and at least one 50-89% coronary stenosis were identified; those patients thought to require PCI (n=1,716) were selected. Of these, 962 (56%) were treated based on angiography (XA) alone, whereas 754 patients (44%) had an FFR-guided treatment. In the latter group, 321 patients (43%) were reallocated to another treatment, predominantly medical treatment. After propensity score matching, the number of indicated lesions was 957 in the XA-guided group and 947 in the FFR-guided group. FFR guidance resulted in PCI deferral in 462 lesions (48.8%). In a seven-day landmark analysis, the rate of periprocedural myocardial infarction (MI) was less than half in the FFR-guided group (p>0.05). For the eight-day to four-year follow-up period, FFR guidance resulted in a significantly lower rate of the combined endpoint of death/MI (hazard ratio [HR] 0.63) and MI-driven target lesion revascularisation (HR 0.35).
  
  
  CONCLUSIONS
  This large, retrospective study shows that performing FFR has a significant impact on therapeutic strategy and demonstrates the favourable long-term outcome of FFR-guided PCI in an "all-comers" population of patients with stable CAD in daily clinical practice.
authors: The Heart Center, Rigshospitalet University Hospital, Copenhagen, Denmark.
authors: Ole
authors: O
authors: De Backer
authors: Luigi
authors: L
authors: Biasco
authors: Jacob
authors: J
authors: Lønborg
authors: Frants
authors: F
authors: Pedersen
authors: Lene
authors: L
authors: Holmvang
authors: Henning
authors: H
authors: Kelbaek
authors: Samer
authors: S
authors: Arnous
authors: Kari
authors: K
authors: Saunamäki
authors: Steffen
authors: S
authors: Helqvist
authors: Jens
authors: J
authors: Kastrup
authors: Erik
authors: E
authors: Jørgensen
authors: Thomas
authors: T
authors: Engstrøm
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000601:surgery*; D023921:Coronary Stenosis / Q000628:therapy*; D005260:Female; D053805:Fractional Flow Reserve, Myocardial / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome