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Risk model using FFR predicted deferred lesion intervention
A prediction model using fractional flow reserve and five clinical variables may aid clinicians in predicting risk for deferred lesion intervention during the first year after FFR assessment, according to recent findings.
The researchers aimed to develop a model that predicted estimated 1-year risk for deferred lesion intervention in coronary lesions in which revascularization was not performed after assessment with FFR.
The analysis included 721 patients with 882 lesions. Eligible lesions had been deferred based on FFR assessment. The researchers defined deferred lesion intervention as any revascularization of a lesion that had been deferred previously after FFR. They used a stepwise Cox regression to develop the model and validated it using bootstrapping techniques.
Patients were accrued between October 2002 and July 2010. The mean follow-up duration was 4 ± 2.3 years.
Deferred lesion intervention was performed in 18% of the lesions that were deferred after FFR.
Results indicated a 5.3% rate of deferred lesion intervention at 1 year. The predicted risk of deferred lesion intervention varied from 1% to 40%, according to the results.
FFR value, age, current or former smoking status, history of CAD or previous PCI, multivessel CAD and serum creatinine were the variables included in the final Cox model. The results indicated a c statistic of 0.66 (95% CI, 0.61-0.70) for the deferred lesion intervention prediction model.
“Patients deferred revascularization based on FFR have variation in their risk for [deferred lesion intervention],” the researchers concluded. “A clinical prediction model consisting of five clinical variables and the FFR value can help predict the risk of [deferred lesion intervention] in the first year following FFR assessment.”
Disclosure: The researchers report financial disclosures with Abbott Vascular, AstraZeneca, Boston Scientific, Bristol-Myers Squibb, Eli Lilly, Medtronic Vascular, Merck, Pfizer, Roche, Schering-Plough, St. Jude Medical, The Medicines Company and Volcano Corp.