Back to Search
Start Over
Clinical outcomes of patients with deferred revascularisation based on fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) negative coronary artery lesions in Pakistani population.
- Source :
-
JPMA. The Journal of the Pakistan Medical Association [J Pak Med Assoc] 2024 Sep; Vol. 74 (9), pp. 1598-1602. - Publication Year :
- 2024
-
Abstract
- Objective: To assess long-term clinical outcomes and factors associated with target vessel revascularisation in patients with deferred revascularisation based on negative fractional flow reserve and negative instantaneous wave-free ratio.<br />Methods: The longitudinal, retrospective study was conducted from July 1, 2020, to January 1, 2022, at the Aga Khan University Hospital, Karachi, and comprised medical records from January 2012 to January 2020 of patients with deferred revascularisation having intermediate to severe coronary lesions on coronary angiogram and had negative fractional flow reserve >0.80 or instantaneous wave-free ratio >0.89 and had not undergone immediate or planned revascularisation on the basis of negative physiological assessment. Data was collected from the institutional records, while final follow-up was taken by reviewing the medical records or telephonic interviews regarding any major adverse cardiac event after the index procedure. Data was analysed using Stata 14.2.<br />Results: Of the 345 patients, 245(71%) were males. The overall mean age was 62±11 years. There were 194(56%) patients who presented with stable angina and 151(44%) presented with acute coronary syndrome. Mean fractional flow reserve was 0.87±0.04 and mean instantaneous wave-free ratio was 0.93±0.03. Multivessel disease was present in 223(65%) patients. Median follow-up period was 29 months (IQR: 24-36 months). Major adverse cardiovascular events occurred in 22(6%) patients, and target vessel revascularisation was required in 11(3%). Diabetes and percentage of stenosis were found to be independent predictors of major adverse cardiovascular events (p<0.05).<br />Conclusions: Deferral of revascularisation and opting for medical treatment for coronary artery stenosis with higher fractional flow reserve or instantaneous wave-free ratio could be considered a safe and reasonable strategy.
- Subjects :
- Humans
Male
Female
Middle Aged
Pakistan epidemiology
Retrospective Studies
Aged
Coronary Artery Disease surgery
Coronary Artery Disease physiopathology
Longitudinal Studies
Coronary Stenosis physiopathology
Coronary Stenosis surgery
Acute Coronary Syndrome surgery
Acute Coronary Syndrome physiopathology
Angina, Stable surgery
Angina, Stable physiopathology
Treatment Outcome
Percutaneous Coronary Intervention methods
Fractional Flow Reserve, Myocardial physiology
Myocardial Revascularization methods
Myocardial Revascularization statistics & numerical data
Coronary Angiography
Subjects
Details
- Language :
- English
- ISSN :
- 0030-9982
- Volume :
- 74
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- JPMA. The Journal of the Pakistan Medical Association
- Publication Type :
- Academic Journal
- Accession number :
- 39279060
- Full Text :
- https://doi.org/10.47391/JPMA.9272