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Diagnostic coronary angiography: Functional flow reserve changes decisions in 25 percent of cases
Date:5/24/2013

23 May 2013, Paris, France: Routinely measuring fractional flow reserve (FFR) using pressure wire assessment during coronary angiography for diagnosis of chest pain leads to significant changes in the management of one in four patients, according to results from a study reported at EuroPCR 2013.

The RIPCORD (Does routine pressure wire assessment influence management strategy at coronary angiography for diagnosis of chest pain) study was designed to assess whether routine assessment of FFR in all the main coronary branches would significantly change the management strategy derived from diagnostic angiography alone.

"Angiographic assessment of chest pain is flawed because it doesn't assess the functional significance of coronary artery disease," said the lead author of the study Nick Curzen, Professor of Interventional Cardiology, University Hospital Southampton NHS Foundation Trust and Faculty of Medicine, University of Southampton, Southampton, UK.

He explained that ischaemia is the most important determinant of clinical outcome in coronary artery disease. FFR provides an accurate and reproducible method for detection of ischaemia by measuring the pressure drop across a lesion and previous studies have shown better clinical outcomes of FFR-guided treatment compared to angiography alone. "But, despite this, most patients with chest pain are assessed by angiogram alone," he told the conference.

RIPCORD recruited 200 patients being investigated for chest pain at 10 UK centres. They all underwent diagnostic coronary angiography carried out by one cardiologist who used the results to develop a treatment plan (plan 1) giving recommendations for medical treatment, percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG) or to request more information.

The first cardiologist then left the room and each patient in the study had FFR measured in all patent vessels of stentable (>2.25mm) diameter by
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Contact: Isabelle Uzielli
iuzielli@europcr.com
European Society of Cardiology
Source:Eurekalert

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