AAFRACTIONAL FLOW RESERVE-GUIDED PCI IN PATIENTS WITH MULTIVESSEL CORONARY ARTERY DISEASE
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Keywords
fractional flow reserve, percutaneous coronary intervention, multivessel coronary artery disease
Abstract
Objectives: To evaluate the clinical outcomes of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) in patients with multivessel coronary artery disease (CAD).
Materials and Methods: This RCT, conducted after ethical committee approval, enrolled 156 patients, all of whom provided informed consent. Patients were randomly assigned to either Group A (FFR-guided PCI) or Group B (angiography-guided PCI). Group A received treatment based on FFR measurements, while Group B underwent PCI without FFR guidance. The primary endpoint was major adverse cardiac events (MACE) at one year, with secondary endpoints including angina improvement, quality of life, and angiographic success. SPSS Version 25 was used for statistical analysis.
Results: A total of 156 patients (mean age 55.28±9.09 years) were enrolled, with 53.2% male and 46.8% female. Group A had lower MACE rates (11.5% vs. 21.8%, p=0.08) and better angina improvement (82.1% vs. 65.4%, p=0.18) compared to Group B. Mortality, myocardial infarction, and revascularization rates were slightly lower in Group A, with angiographic success also higher (94.9% vs. 87.2%, p=0.09).
Conclusion: In conclusion, FFR-guided PCI in multivessel coronary artery disease offers a more precise approach to revascularization by targeting functionally significant lesions, leading to better clinical outcomes, including reduced MACE, myocardial infarction, and revascularization, along with improved angina relief. Further studies are needed to confirm its long-term benefits and cost-effectiveness.
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Dr Rahid Ayaz
Fellow Interventional Cardiology, Lady Reading Hospital MTI, Peshawar, Pakistan
Dr Maleeha Ahmad
Medical Officer, Medicine Department, Swat Medical Complex Teaching Hospital (SMCTH), Pakistan
Dr Sanaullah Khan
MBBS, FCPS Cardiology, Medical Officer, Cardiology Unit, Tehsil Headquarter Hospital, Khwazakhela Swat, Pakistan
Dr Marium Shahzad
Medical Officer, Medicine Department, Imran Idrees Teaching Hospital / Sialkot Medical College, Pakistan
Dr Tayyabuddin Khand
Assistant Professor Biochemistry Mekran Medical College, Turbat, Pakistan
Dr Mahboob Ur Rehman
Associate Professor, Department of Cardiology, Cardiac Centre PIMS, Islamabad, Pakistan