LONG-TERM OUTCOMES OF FRACTIONAL FLOW RESERVE-GUIDED PCI IN PATIENTS WITH MULTIVESSEL DISEASE
DOI:
https://doi.org/10.55519/JAMC-S4-14762Abstract
Background: Percutaneous coronary intervention (PCI) has long been a cornerstone in managing coronary artery disease (CAD), particularly in patients with multivessel disease (MVD). Traditionally guided by angiographic assessment, PCI strategies have evolved with the advent of fractional flow reserve (FFR), a physiological tool that quantifies the functional severity of coronary stenosis. This study investigates the long-term clinical outcomes of FFR-guided PCI in MVD patients, addressing a critical gap in existing literature that predominantly focuses on short- to mid-term results. Methods: A retrospective cohort of 300 patients diagnosed with MVD underwent FFR-guided PCI between 2010 and 2015. FFR measurements determined the need for intervention, with values ≤0.80 indicating hemodynamically significant lesions warranting PCI. Patients were followed for two years, with outcomes including mortality, myocardial infarction (MI), repeat revascularization, and major adverse cardiac events (MACE) assessed. Results: Findings revealed that patients with FFR <0.80 had more complex disease and required more extensive interventions, including higher rates of multi-vessel PCI and stent implantation. Despite similar procedural success, this group experienced significantly higher rates of repeat revascularization and MACE compared to those with FFR >0.80. Notably, deferring PCI in lesions with FFR >0.80 was associated with better long-term outcomes and reduced procedural burden. Conclusion: The study underscores the prognostic and economic value of FFR-guided PCI, demonstrating its role in optimizing treatment strategies, minimizing unnecessary interventions, and improving long-term cardiovascular health. These results advocate for broader adoption of FFR in routine clinical practice, especially in MVD cases where functional assessment enhances decision-making and patient outcomes.
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