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Category: Volume 07 Issue 06 June 2019
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Title: Operational Utility of Fractional Flow Reserve in Guiding the Decision for Coronary Revascularization in Patients of Coronary Artery Disease in Indian Scenario

Authors: Vikram Singh, Sheikh Mohamad Tahir, Jasmine Kang, Shubana Ashraf

 DOI: https://dx.doi.org/10.18535/jmscr/v7i6.80

Abstract

Background: Atherosclerotic coronary heart disease (CHD) is the commonest non-communicable disease worldwide and contributes to more than 1.2 million myocardial infarctions and nearly 500,000 deaths each year. The aim of the study was to assess FFR in patients with coronary lesions of intermediate/uncertain severity after conventional CAG and derive revascularization decision thereby. To assess how often FFR changes revascularization decisions in such patients and to analyse inter observer variability in angiographic decision making between experienced operators in coronary lesions of intermediate/uncertain severity.

Methods: We enrolled 40 patients with coronary lesions of intermediate/uncertain severity whose revascularization decision remained ambiguous as assessed by the primary operator after clinical and non-invasive data (TMT, DSE, stress MIBI) and coronary angiography.

Results: A total of 40 patients were enrolled for the study among which 79.3% were males and 20.7% females. The Mean age (± SD) in female group was 64.5± 6.097 years and that in male group was 59.3± 11.02 years. Eight coronary lesions were found to be of intermediate/ uncertain severity and were subjected to FFR. All lesions having FFR ≤ 0.8 underwent intervention while none of the lesion having FFR value of ≥ 0.8 were intervened. So there was significant association found between FFR value and decision changed.

Conclusion: FFR provides a reliable and objective assessment of intermediate/uncertain lesions leading to better revascularization decisions.

Keywords: Coronary Revascularization, coronary artery disease, Fractional Flow Reserve, FFR.

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Corresponding Author

Sheikh Mohamad Tahir

Consultant Cardiologist, Super Speciality Hospital, Government Medical College, J&K, India