Photo Credit: Alena Butusava
The following is a summary of “Use of coronary physiology to guide revascularization in clinical practice: results of the F(FR)2 registry,” published in the June 2024 issue of Cardiology by Altstidl et al.
Even though coronary physiology is recommended to guide revascularization in angiographically intermediate stenoses without established correlation to ischemia, it is not widely used in real-world practice.
Researchers conducted a retrospective study to determine how often coronary physiology is used in clinical settings.
They used data from the Fractional Flow Reserve Fax Registry (F(FR)2, ClinicalTrials.gov ID NCT03055910), to systematically analyze how coronary physiology was used in practice, including its consequences and complications, across multiple centers.
The results showed that F(FR)2 included 2,000 patients with 3,378 intracoronary pressure measurements, mostly in angiographically intermediate stenoses (96.8%). Of 3,238 lesions, revascularization was deferred in 2,643 cases (78.2%). The FFR was the main pressure index used (87.6%), with intracoronary adenosine in 2,556 lesions (86.4%) and intravenous adenosine in 384 cases (13.0%). The adenosine administration route didn’t affect FFR results. Agreement with revascularization decisions was 93.4% for intravenous and 95.0% for intracoronary adenosine (P=0.261). Complications included 2 coronary occlusions (0.1%) and 3 dissections (0.2%), with 1 fatality (0.1%).
Investigators concluded that intracoronary pressure measurements mainly guided revascularization in intermediate stenoses, with both intracoronary and intravenous adenosine equally effective. Complications were rare and not negligible in clinical practice.
Source: link.springer.com/article/10.1007/s00392-024-02463-w
