Analysis Of Influence Of Fractional Flow Reserve-guided Percutaneous Coronary Intervention On Adverse Cardiac Events

Objective:Fractional flow reserve (FFR) is the reference standard for the assessment of the functional significance of coronary artery stenosis.This study aims to compare outcomes of fractional flow reserve-guided percutaneous coronary intervention (FFR-guided PCI) and coronary angiography-guided percutaneous coronary intervention(CAG-guided PCI) in the general clinical practice in patients with coronary lesion and then study its influence on adverse cardiac events.Methods:In this retrospective study, consecutive patients (n=110), whose first-listed diagnose were stable angina pectoris,coronary angiography of them revealed single coronary artery focal stenosis between 70-80% and diameters of arteries were more than 2.5mm, referred for PCI at the Second Affiliated Hospital of Kunming Medical University between October 2012 and April 2014, were divided in two groups:those undergoing PCI without FFR measurements, which was defined as PCI-group(n =89); Those undergoing FFR measurements, which was defined as FFR-group (n=21),the second group was further classified as the FFR-Y group (n=11) if followed by PCI, and the FFR-N group (n=10) if PCI was not performed. Clinical events were compared during a follow-up of 12 months.Results:In this study, we compared information of clinical ending events of patients in PCI-group vs. FFR group,there was one patient died of unknown reasons in PCI-group,the occurrence rate of MACE in PCI group was 1.12% vs.0.00% in FFR group.There were totally four patients investigated in-hospital events in PCI group,three of those four are found ST segment changing,the other one were found T wave inversion,the occurrence rate of in-hospital events in PCI group was 4.49% vs. 0.00% in FFR group.There were totally fourteen out-hospital events investigated in PCI group,half of them were recurrence of angina,the others were ST-T changing found in Holter records,and there was one patients investigated recurrence of angina,the occurrence rate of out-hospital events in PCI group was 15.73%vs. 4.76% in FFR group.There was no MACE and in/out-hospital events investigated in FFR-Y group.Difference above was no statistical significance,P>0.05.The occurrence rate of MACE,in/out-hospital events in FFR group was lower than that in PCI group. Conclusion:Compared with CAG-guided PCI,FFR-guided PCI may decrease occurrence rate of adverse cardiac events.