Arq. Bras. Cardiol. 2023; 120(6): e20230363
Is it Time to Revisit Fractional Flow Reserve Thresholds?
Fernando Mendes Sant’Anna
, Lucas Bonacossa Sant’Anna
, Sérgio Lívio Menezes Couceiro
This Short Editorial is referred by the Research article "Prognostic Assessment of Fractional Flow Reserve in Different Strata in Patients with Coronary Artery Disease".
Intracoronary physiological assessment is established as a valuable strategy to identify flow-limiting epicardial stenoses in patients with coronary artery disease (CAD) and to determine an indication for percutaneous coronary interventions (PCI).
It had been previously assumed that once the flow-limiting disease was confirmed with a pressure guidewire measurement, PCI guided by angiography should lead to effective restoration of vessel conductance. However, studies with physiological post-PCI evaluation based on fractional flow reserve (FFR) and non-hyperemic pressure ratios (NHPR) demonstrate that this supposition is not correct and that relying on angiographic guidance alone can be associated with suboptimal functional results post-PCI in many cases. , Moreover, it is well known that post-PCI FFR is a strong predictor of outcomes, and the lower the post-stent FFR, the worse the clinical follow-up.
[…]
286
