DOI: doi.org/10.1016/j.ijca…
Drs @SukhNijjer, @jerd10 and @RicardoPetraco. What are your views on @DavidLBrownMD fallacies of FFR?
As a budding interventional cardiologist, I like to hear all opinions and sides to the story :)
Drs @SukhNijjer, @jerd10 and @RicardoPetraco. What are your views on @DavidLBrownMD fallacies of FFR?
As a budding interventional cardiologist, I like to hear all opinions and sides to the story :)
“In conclusion, FFR in isolation is of no proven clinical value in the evaluation of patients with suspected ischemia. The ESC guidelines continue to promote an outdated paradigm for the evaluation of suspected ischemia that focuses on the focal epicardial stenosis.”
The 4 fallacies
1/4 - The first fallacy is the foundational premise of FFR that ischemia caused by a focal obstructive epicardial coronary stenosis is on the direct pathway to death or MI and therefore should be a target of revascularization
1/4 - The first fallacy is the foundational premise of FFR that ischemia caused by a focal obstructive epicardial coronary stenosis is on the direct pathway to death or MI and therefore should be a target of revascularization
2/4 - A second fallacy is that the microvasculature is irrelevant in the assessment of coronary physiology and pathophysiology in patients with angina.
3/4 - 3rd fallacy is that FFR-guided PCI improves outcomes through targeted lesion selection as asserted in the FAME trial, which found that measurement of FFR in patients undergoing PCI significantly red death or nonfatal MI at 1 year by
34% cf. to lesion selection using angio
34% cf. to lesion selection using angio
4/4 - A fourth fallacy is that FFR -guided PCI improves outcomes compared to optimal medical therapy (OMT).
