Survival of Patients With Angina Pectoris Undergoing Percutaneous Coronary Intervention With Intracoronary Pressure Wire Guidance

Sebastian Völz, Christian Dworeck, Björn Redfors, Pétur Pétursson, Oskar Angerås, Li Ming Gan, Matthias Götberg, Giovanna Sarno, Dimitrios Venetsanos, Per Grimfärd, Robin Hofmann, Jens Jensen, Fredrik Björklund, Mikael Danielewicz, Rickard Linder, Truls Råmunddal, Ole Fröbert, Nils Witt, Stefan James, David ErlingeElmir Omerovic

Research output: Contribution to journalArticlepeer-review

16 Citations (SciVal)

Abstract

Background: Intracoronary pressure wire measurement of fractional flow reserve (FFR) provides decision-making guidance during percutaneous coronary intervention (PCI). However, limited data exist on the effect of FFR on long-term clinical outcomes in patients with stable angina pectoris. Objectives: The purpose of this study was to determine the association between the usage of FFR and all-cause mortality in patients with stable angina undergoing PCI. Methods: Data was used from the SCAAR (Swedish Coronary Angiography and Angioplasty Registry) on all patients undergoing PCI (with or without FFR guidance) for stable angina pectoris in Sweden between January 2005 and March 2016. The primary endpoint was all-cause mortality, and the secondary endpoints were stent thrombosis (ST) or restenosis and peri-procedural complications. The primary model was multilevel Cox proportional hazards regression adjusted with Kernel-based propensity score matching. Results: In total, 23,860 patients underwent PCI for stable angina pectoris; of these, FFR guidance was used in 3,367. After a median follow-up of 4.7 years (range 0 to 11.2 years), the FFR group had lower adjusted risk estimates for all-cause mortality (hazard ratio: 0.81; 95% confidence interval [CI]: 0.73 to 0.89; p < 0.001), and ST and restenosis (hazard ratio: 0.74; 95% CI: 0.57 to 0.96; p = 0.022). The number of peri-procedural complications did not differ between the groups (adjusted odds ratio: 0.96; 95% CI: 0.77 to 1.19; p = 0.697). Conclusions: In this observational study, the use of FFR was associated with a lower risk of long-term mortality, ST, and restenosis in patients undergoing PCI for stable angina pectoris. This study supports the current European and American guidelines for the use of FFR during PCI and shows that intracoronary pressure wire guidance confers prognostic benefit in patients with stable angina pectoris.

Original languageEnglish
Pages (from-to)2785-2799
Number of pages15
JournalJournal of the American College of Cardiology
Volume75
Issue number22
DOIs
Publication statusPublished - 2020

Subject classification (UKÄ)

  • Cardiac and Cardiovascular Systems

Keywords

  • coronary artery disease
  • fractional flow reserve
  • percutaneous coronary intervention
  • stable angina pectoris

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