FFR led to revised treatment strategy in nearly half of patients

PARIS — Data from the POST-IT Registry have shown that the use of fractional flow reserve at the time of diagnostic angiography changed the treatment strategy of 44.3% of patients.

“We know that FFR-guided myocardial revascularization has been shown to be safe and improve clinical outcomes in randomized clinical trials, but information concerning real-world patients is quite limited,” Sergio Baptista, MD, interventional cardiologist at the Hospital Fernando Fonseca, Amadora, Portugal, said during a press conference at EuroPCR.

The purpose of this study, Baptista said, was to describe the patterns of use of FFR in a real-world population and to determine the extent of which the information gained has an impact on the final patient management strategy.

In the study, Baptista and fellow investigators examined 918 consecutive patients (lesions, n=1,293) from the national, prospective POST-IT Registry, which includes 19 centers in Portugal. Patients were enrolled from April 2012 to November 2013, 48.4% had prior functional non-invasive testing or multi-slice CT and 35.4% had ACS.

Before FFR determination, researchers established a treatment plan for each lesion — revascularization, medical therapy or non-invasive stress test — based on all available information. At the end of the procedure, researchers documented agreement between the final and initial strategies per lesion and per patient.

Data indicated that there was a change in treatment strategy in 44.3% of patients following use of FFR.

The majority of the 319 patients initially planned for PCI received the strategy (72%), while 25% received medical therapy and 3% received CABG.

Among patients initially planned for medical therapy (n=361), the strategy was changed in 27% of patients (23% received PCI, 4% received CABG), whereas among those who were initially planned for CABG (n=36), 44% received a different treatment (PCI, 25%; medical therapy, 19%).

And for those who had an initial strategy planned of a noninvasive stress test (n=202), 47% were treated with medical therapy, 40% with PCI and 13% with CABG.

Baptista said that data on the 1-year clinical results, mainly adverse events, will be available later this year. – by Brian Ellis

For more information:

Baptista S. Hot line: PCI registries. Presented at: EuroPCR; May 20-23, 2014; Paris.

Disclosure: Baptista reports receiving institutional grant/research support from St. Jude Medical. The study was supported by a non-restricted grant from St. Jude Medical.