Fractional Flow Reserve: Does a Cut-off Value add Value?

Mohdnazri, Shah R. and Keeble, Thomas R. and Sharp, Andrew S. P. (2016) Fractional Flow Reserve: Does a Cut-off Value add Value? Interventional Cardiology Review, 11 (1). p. 17. ISSN 1756-1485

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Fractional flow reserve (FFR) has been shown to improve outcomes when used to guide percutaneous coronary intervention (PCI). There have been two proposed cut-off points for FFR. The first was derived by comparing FFR against a series of non-invasive tests, with a value of ≤0.75 shown to predict a positive ischaemia test. It was then shown in the DEFER study that a vessel FFR value of ≥0.75 was associated with safe deferral of PCI. During the validation phase, a ‘grey zone’ for FFR values of between 0.76 and 0.80 was demonstrated, where a positive non-invasive test may still occur, but sensitivity and specificity were sub-optimal. Clinical judgement was therefore advised for values in this range. The FAME studies then moved the FFR cut-off point to ≤0.80, with a view to predicting outcomes. The ≤0.80 cut-off point has been adopted into clinical practice guidelines, whereas the lower value of ≤0.75 is no longer widely used. Here, the authors discuss the data underpinning these cut-off values and the practical implications for their use when using FFR guidance in PCI.

Item Type: Journal Article
Keywords: coronary physiology, fractional flow reserve, pressure wire
Faculty: ARCHIVED Faculty of Medical Science (until September 2018)
Depositing User: Ian Walker
Date Deposited: 08 Aug 2019 10:26
Last Modified: 09 Sep 2021 16:14

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