title: Clinical Application of Fractional Flow Reserve-Guided Percutaneous Coronary Intervention for Stable Coronary Artery Disease.
abstract: Revascularization in stable ischemic heart disease (SIHD) is indicated in patients on optimal medical therapy with angina and/or demonstrable ischemia and a significant stenosis in one or more epicardial coronary arteries. Angiography alone, however, cannot accurately determine the hemodynamic significance of coronary lesions, particularly those of intermediate stenosis severity. A lesion may appear significant on coronary angiogram but may not have functional significance. Percutaneous coronary intervention (PCI) of functionally insignificant coronary artery lesions may have serious consequences; therefore, judicious decision-making in the cardiac catheterization laboratory is indicated. For this reason, it is becoming increasingly important to show that a stenosis is capable to induce myocardial ischemia prior to intervention. Fractional flow reserve (FFR) has emerged as a useful tool for this purpose. In this review, we will briefly discuss the principle of FFR, current evidence and rationale supporting its use, and comparison with other modalities.
authors.affiliation: Staten Island University Hospital, 475 Seaview Ave, Staten Island, NY, 10305, USA. valayparikh@gmail.com.
authors.forename: Valay
authors.initials: V
authors.lastname: Parikh
authors.affiliation: Saint Peter's University Hospital, New Brunswick, NJ, USA.
authors.forename: Kanishk
authors.initials: K
authors.lastname: Agnihotri
authors.affiliation: Lincoln Medical and Mental Health Center, Bronx, NY, USA.
authors.forename: Sabeeda
authors.initials: S
authors.lastname: Kadavath
authors.affiliation: University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Nileshkumar J
authors.initials: NJ
authors.lastname: Patel
authors.affiliation: Brown University, Providence, RI, USA.
authors.forename: J Dawn
authors.initials: JD
authors.lastname: Abbott
mesh_terms: D017023:Coronary Angiography / Q000379:methods; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000601:surgery*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D053805:Fractional Flow Reserve, Myocardial; D006439:Hemodynamics; D006801:Humans; D062645:Percutaneous Coronary Intervention / Q000592:standards*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
keywords: Coronary artery disease; FFR; Percutaneous coronary intervention; Stable ischemic heart disease