1 / 7

FFR and the New ESC Guidelines

I A. FFR and the New ESC Guidelines. FFR Awarded Strongest Recommendation, Highest Level of Evidence: I A. Key Points.

tamra
Download Presentation

FFR and the New ESC Guidelines

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. I A FFR and the New ESC Guidelines FFR Awarded Strongest Recommendation, Highest Level of Evidence: I A

  2. Key Points • Cardiologists and thoracic surgeons together, have written recommendations for when a patient should be revascularized (treated by PCI or CABG) rather than treated by optimal medical therapy alone. • New guidelines: Functional testing (non-invasive test or FFR) is key in determining whether or not a patient should be revascularized*. • FFR has been given the highest possible recommendation: Class ILevel of Evidence A * Wijns, et al., EurHeart J (2010) 31(20): 2501-2555 first published online August 29, 2010

  3. Only FFR and DES = I A 3

  4. Recommendation I A = Strongest I A = FFR is generally accepted as valuable; strong evidence exists to support its use. 4

  5. FFR Should be Used Before Deciding on Treatment For the treating physician, the new guidelines mean that he should measure FFR before making a decision to perform PCI or send the patient to surgery, in patients who come to the cath lab without a prior functional test and with a stenosis(es)50-90% by angiography. This is regardless of whether the patient has single-vessel disease, multivessel disease, or if the vessel is especially important, eg. proximal LAD or LMCA. 5

  6. FFR vs Other Functional Tests • Non-invasive tests • We know that in many countries, up to 50% of patients come to the coronary cath lab without any prior functional test1If results from a prior functional test are available, even in the case of the most sophisticated tests, the results are not always reliable, especially in multivessel disease. • FFR • A functional test that can be performed in the cath lab. • A specific functional test that is useful and reliable in the majority of patients. • The FAME Study2has shown that FFR reduces mortality, reduces costs and doesn’t increase procedure time.

  7. References • Grace A. Lin; R. Adams Dudley; F. L. Lucas; et al. Prior to Elective Percutaneous Coronary Intervention Frequency of Stress Testing to Document Ischemia, JAMA. 2008;300(15):1765-1773 (doi:10.1001/jama.300.15.1765) • Pim A.L. Tonino, et al. Fractional Flow Reserve versus Angiography for Guiding Percutaneous Coronary Intervention. NEJM 2009;360;3:213-24 7

More Related