Outcomes of Fractional Flow Reserve-guided Deferred Coronary Revascularization

Heart Views. 2024 Oct-Dec;25(4):223-228. doi: 10.4103/heartviews.heartviews_76_24. Epub 2025 May 10.

Abstract

Context: Fractional flow reserve (FFR) is used to assess the functional significance of intermediate coronary stenosis. An FFR value of 0.80 or less identifies significant lesions, whereas higher values do not require revascularization. The rate of deferred lesion revascularization (DLR) differs among studies.

Aims: This study aims to evaluate the outcome of deferring revascularization in intermediate coronary stenoses in angiography with nonischemic values in FFR assessment.

Settings and design: This study was conducted in a single center from March 2013 to August 2017.

Subjects and methods: The study involved patients diagnosed with moderate (50%-69%) coronary stenosis and noninfarcted FFR (>0.8). All patients were followed up, and total mortality and DLR were recorded.

Statistical analysis used: Fisher exact statistical test was used to compare descriptive variables, and the Mann-Whitney statistical test was used for quantitative variables.

Results: There were 115 patients with a mean age of 58.35 ± 10.07 years; 71 (61.7%) were male. The mean (range) follow-up period was 32 ± 15 (6-60) months. The mortality rate was 0.8%, and 4.8% of patients had revascularization during the follow-up period.

Conclusions: Deferring revascularization and medical management for intermediate coronary lesions with nonischemic FFR (>0.8) are a safe strategy.

Keywords: Angiography; coronary physiology; coronary stenosis; fractional flow reserve.