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Performance and 12 month outcomes of a wire free fractional flow reserve system for assessment of coronary artery disease, first experience in south east asia

Title: Performance and 12 month outcomes of a wire free fractional flow reserve system for assessment of coronary artery disease, first experience in south east asia
Authors: Bhavnani, C D; Fong, A Y Y; Koh, K T; Oon, Y Y; Tan, C T; Chen, L S; Pang, I X; Said, A B; Ho, K H; Shu, F E P; Ling, H S; Cham, Y L; Thien, L K; Chung, B K; Ong, T K
Source: European Heart Journal ; volume 43, issue Supplement_1 ; ISSN 0195-668X 1522-9645
Publisher Information: Oxford University Press (OUP)
Publication Year: 2022
Description: Funding Acknowledgements Type of funding sources: None. Background Fractional flow reserve (FFR) using an invasive pressure wire has a Class 1A recommendation for guiding coronary revascularization in stable coronary artery disease (CAD). Angiography based ‘wire free’ FFR is an emerging technique which determines the physiological significance of a coronary lesion without requirement of a pressure wire or induction of hyperemia. It also eliminates potential complications associated with introduction of wires into the coronary arteries. Objective To assess the 12-month clinical outcomes of PCI deferral, guided by an angiography based fractional flow reserve (CAFFR) system. The primary end point was a composite of death from any cause, myocardial infarction (MI) or target vessel revascularization (TVR) Methods This was a prospective, single center study involving 69 patients (93 vessels) with angiographic stenosis of 30%-90%. Patients with CAFFR of 0.80 and thus, PCI deferral. Wired FFR was done for comparison on 14 patients (48%) at the operator’s discretion. Results The mean age was 59 ± 12.6 years old. Majority of patients (83%) were male. 12 (42%) patients were diabetic, 18 (62%) were hypertensive, 17 (59%) had dyslipidemia and 18 (62%) had a smoking history. The mean LVEF was 52+/-11.4%. 72% of the patients had a recent acute coronary syndrome. We assessed the LAD artery in 15 (52%) vessels. The mean CAFFR and FFR was 0.87 ± 0.04 and 0.89 ± 0.05 respectively. The values showed agreement with each other with no statistically significant proportional bias on the Bland Altman plot (linear regression t test: t=-1.19, p = 0.257). CAFFR values >0.80 showed 100% correspondence to negative FFR values (>0.80). There were zero procedural complications from CAFFR measurement. At 12 months, all 29 patients were alive. Only 1 patient (3.4%) met the primary end ...
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/eurheartj/ehab849.122
Availability: https://doi.org/10.1093/eurheartj/ehab849.122; https://academic.oup.com/eurheartj/article-pdf/43/Supplement_1/ehab849.122/42377135/ehab849.122.pdf
Rights: https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model
Accession Number: edsbas.1A31370C
Database: BASE