$Clinical outcomes after intravascular ultrasound and fractional flow reserve assessment of intermediate coronary lesions. Propensity score matching of large cohorts from two institutions with a differential approach$
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Clinical outcomes after intravascular ultrasound and fractional flow reserve assessment of intermediate coronary lesions. Propensity score matching of large cohorts from two institutions with a differential approach

Assessment of intermediate coronary lesions can be done with fractional flow reserve (FFR) and intravascular ultrasound (IVUS). There are no randomised trials and only a small registry from one centre is available but this is subject to important bias. We sought to evaluate the clinical outcomes of...

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Bibliographic Details
Published in:	EuroIntervention Vol. 9; no. 7; pp. 824 - 830
Main Authors:	de la Torre Hernandez, Jose M, Lopez-Palop, Ramon, Garcia Camarero, Tamara, Carrillo Saez, Pilar, Martin Gorria, Gonzalo, Frutos Garcia, Araceli, Arnaez Corada, Blanca, Cordero Fort, Alberto, Gomez Delgado, Jenny M, Agudo Quilez, Pilar, Lee, Dae-Hyun, Rodriguez, Irene Mateo, Sainz Laso, Fermin, Khashaba, Ahmed, Miralles Arques, Sandra, Zueco Gil, Javier
Format:	Journal Article
Language:	English
Published:	France 01-11-2013
Subjects:	Coronary Angiography Coronary Stenosis - diagnostic imaging Fractional Flow Reserve, Myocardial Humans Propensity Score Ultrasonography, Interventional
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Summary:	Assessment of intermediate coronary lesions can be done with fractional flow reserve (FFR) and intravascular ultrasound (IVUS). There are no randomised trials and only a small registry from one centre is available but this is subject to important bias. We sought to evaluate the clinical outcomes of an FFR strategy compared with an IVUS strategy for intermediate lesion assessment. We compared the outcome of patients assessed with FFR and IVUS in two centres with a differential approach. After propensity score matching 400 pairs of patients were included. Revascularisation was done when FFR was <0.75 or minimum lumen area was <4 mm2 in vessels >3 mm, and <3.5 mm2 in vessels 2.5-3 mm, along with plaque burden >50%. After FFR and IVUS, 72% and 51.2% of lesions, respectively, were left untreated (p<0.001). At one and two years no significant differences in MACE-free survival were observed in overall groups (97.7% at one year and 93.1% at two years in the FFR group and 97.7% at one year and 95.6% at two years in the IVUS group; p=0.35) and among those with deferred intervention (97.9% at one year and 94.2% at two years in the FFR group and 96.5% at one year and 93.6% at two years in the IVUS group; p=0.7). IVUS and FFR may be safely used to defer revascularisation of intermediate lesions. IVUS induces a higher degree of revascularisation but much lower than previously reported and does not affect the clinical outcome.
ISSN:	1774-024X 1969-6213
DOI:	10.4244/EIJV9I7A136