Application Value Of Fractional Flow Reserve In The Treatment Of Patients With Intermediate Coronary Stenosis

ObjectiveFractional flow reserve(FFR)is a functional tool for evaluating coronary ischemia.This study was designed to investigate the role of FFR in the treatment of intermediate coronary stenosis.MethodsOne hundred and thirty-six patients were recruited in this retrospective study between December 2012 and February 2018,all of whom received coronary angiography(CAG)with 50%-70% of coronary stenosis.There are 51 patients received coronary angiography and 85 patients received FFR-guided coronary angiography.They were divided into coronary angiography group(CAG + medical treatment,Referred to as CAG-medical treatment group)and FFR-guided coronary angiography group(FFR-guided interventional treatment or medical treatment,Referred to as CAGFFR group).In CAG-FFR group,a cut-off value of 0.8 was used.If Target vessel's FFR ? 0.80,percutaneous coronary intervention(PCI)was performed for the corresponding vessel(Referred to as CAG-FFR-PCI group,n=30),and if FFR > 0.80,medical treatment was adopted(Referred to as CAG-FFR-medical treatment group,n=55).A clinical follow-up study of 2 years was performed to observe the difference of major adverse cardiovascular events(MACE)(including cardiogenic death,nonfatal myocardial infarction,and revascularization)and angina pectoris between two groups.ResultsThere were no significant differences between two groups in the patient's general baseline data(age,gender,smoking,hypertension,diabetes,hyperlipidemia,antiplatelet drugs,?-blockers,ACEI or ARB,CCB,statins,nitric acid)and coronary angiography results(P>0.05).The number of MACEs in the CAG-medical treatment group and the CAG-FFR group were 14 and 5,with the incidence rates 25.5% and 5.9%(P<0.05),respectively.The number of revascularizations was 10 and 4,with the incidence rates 19.6% and 4.7%(P<0.05)respectively.The number of patients admitted to hospital due to acute myocardial infarction was 4 and 1,with the incidence rates 5.9% and 1.2%(P>0.05),respectively.The number of people who had at least one onset of angina pectoris during follow-up was 7 and 15,with the incidence of 43.1% and 25.9%(P<0.05),respectively.In the FFR two subgroups,the number of MACEs in the CAG-FFR-PCI group and CAG-FFR-medical treatment group group were 1 and 4.The number of revascularizations was 0 and 4.The number of patients admitted to hospital due to acute myocardial infarction was 1 and 0.The number of people who had at least one onset of angina pectoris during follow-up was 7 and 15.There were no significant differences between two groups in MACE,angina pectoristhe,patient's general baseline data and coronary angiography results(P>0.05).ConclusionsFFR-guided PCI treatment and deferred revascularization are safe.It can significantly reduce the incidence of major adverse cardiovascular events.