%0 Journal Article
%T Optimal Revascularization Threshold of Fractional Flow Reserve and its Effect on Outcomes: Perspectives From a High
%A Bangguo Yang
%A Hongya Han
%A Jianwei Zhang
%A Qingwei Ji
%A Wei Liu
%A Xiaoli Liu
%A Xiaoteng Ma
%A Yingxin Zhao
%A Yonghe Guo
%A Yu Du
%A Yujie Zhou
%A Zhijian Wang
%J Angiology
%@ 1940-1574
%D 2019
%R 10.1177/0003319718806394
%X This study aimed to investigate the favorable revascularization threshold for fractional flow reserve (FFR) in daily practice. Between March 2013 and March 2017 in a high-volume center in China, 903 patients with 1210 lesions underwent coronary intervention with adjunctive FFR and were consecutively enrolled. The mean FFR was 0.80 ¡À 0.11, revascularization was deferred for 68% of lesions, and the median follow-up period was 21 months. For lesions with an FFR > 0.80, deferral of revascularization appeared safe. In contrast, for lesions with an FFR ¡Ü 0.80, deferral of revascularization was associated with a greater risk of target lesion failure (TLF) than revascularization (hazard ratio [HR] 4.63, 95% confidence interval [CI] 2.02-10.06, P < .001). For lesions with an FFR value in the gray-zone (0.76-0.80), medical treatment alone was less effective than revascularization (P = .020). For deferred lesions, FFR was an independent predictor for the future risk of TLF, when data were categorized (HR [FFR ¡Ü 0.75 vs FFR ¡Ý 0.86] 3.35, 95% CI 1.13-9.97, P = .030; HR [FFR 0.76-0.80 vs FFR ¡Ý 0.86] 4.01, 95% CI 1.73-9.31, P = .001) or continuous (HR 0.004, 95% CI 0.00-0.13, P = .002). Thus, an FFR value of 0.80 appears to be the optimal threshold for decision-making regarding revascularization and risk stratification
%K fractional flow reserve
%K percutaneous coronary intervention
%K revascularization threshold
%K clinical outcome
%U https://journals.sagepub.com/doi/full/10.1177/0003319718806394