Evaluating the impact of fractional flow reserve-guided percutaneous coronary intervention in intermediate coronary artery lesions on the mode of treatment and their outcomes: An Iranian experience

Background: today, the fractional flow reserve (ffr) guides the physician to select suitablepatients with intermediate severity coronary lesions in angiography that should be treated ornot with stent. the aim of this study was to evaluate the impact of using ffr in the selection ofappropriate treatment strategy in angiographic intermediate coronary lesions and their shorttermoutcome in a sample of iranian population.methods: in a prospective cohort, 34 patients who had intermediate coronary artery lesion(s),defined as having a 40-70% diameter stenosis, as determined by visual estimation orquantitative coronary angiography were enrolled through a convenience sampling method. allpatients underwent ffr measurement to decide whether percutaneous coronary interventionshould be performed. the results of visual assessment, quantitative coronary angiography, andfunctional assessment of the severity of coronary stenosis were compared. significant stenosiswas defined as ffr < 0.80. all patients were followed for 6 months for the incidence of majoradvanced cardiac events.results: in this study, 34 patients (22 male and 12 female) with mean age of 57 ± 8 (range45-70) were included. in 26.47% (9/34) of patients, ffr was < 0.80, they underwent coronaryangioplasty. the correlation between visual estimation and quantitative assessment of lesiondiameter was 0.804 (p < 0.001). during the follow-up period, no major advanced cardiac eventswere reported. in addition, 5.88 (2/34) of patients had a left main (lm) lesion with ffr > 0.80and stenting was done to the other vessels with significant coronary lesions.conclusion: measurement of ffr is a useful approach in making clinical decisions aboutrevascularization procedures in patients with moderate coronary artery lesion severity,especially in lm and multivessel disease. this study showed that not only ffr can changetreatment plan of the patients, but also it would improve clinical outcomes.