Clinical outcomes of deferred revascularisation using fractional flow reserve in patients with and without diabetes mellitus

• DOI: 10.1186/s12933-016-0417-2
• Publication Date: 2016-07-18T19:42:14Z
• Authors: Mark W. Kennedy; Eliza Kaplan; Rik S. Hermanides; Enrico Fabris; Veemal Hemradj; Petra C. Koopmans; Jan-Hank E. Dambrink; A. T. Marcel Goss...; Arnoud W. J. van‘...; Jan Paul Ottervanger; Vincent Roolvink; Wouter S. Remkes; Aize van der Sluis; Harry Suryapranata; Elvin Kedhi
• Keywords: Fractional Flow Reserve; Target lesion; Clinical endpoint

Deferred revascularisation based upon fractional flow reserve (FFR >0.80) is associated with a low incidence of target lesion failure (TLF). Whether deferred also as safe in diabetes mellitus (DM) patients unknown.All DM and the next consecutive Non-DM who underwent FFR-assessment between 1/01/2010 31/12/2013 were included, followed until 1/07/2015. Patients lesions FFR >0.80 analysed according to presence vs. absence DM, while index FFR-assessed or other excluded. The primary endpoint was TLF; composite (TLR) vessel myocardial infarction (TVMI).A total 250 (122 128 non-DM) all compared. At mean follow up 39.8 ± 16.3 months, compared non-DM had higher TLF rate, 18.1 vs 7.5 %, logrank p ≤ 0.01, Cox regression-adjusted HR 3.65 (95 % CI 1.40-9.53, < 0.01), which largely driven by TLR (17.2 3.52, 95 1.34-9.30, = whilst non-significant but numerically TVMI (6.1 2.0 3.34, 0.64-17.30, 0.15) observed.This study, largest directly compare clinical outcomes FFR-guided without shows that are significantly rate. intravascular imaging, additional invasive haemodynamics stringent risk factor modification may impact on this rate remains unknown.