The following is a summary of “Modelled impact of virtual fractional flow reserve in patients undergoing coronary angiography (VIRTU-4),” published in the May 2024 issue of Cardiology by Ghobrial et al.
The practicality of ‘virtual’ fractional flow reserve (vFFR) through invasive coronary angiograms (ICA) is still not well known.
Researchers conducted a prospective study to verify whether vFFR could help manage patients who receive ICA in at least 10% of cases.
They used the Sheffield VIRTU heart system to compute vFFR at five hospitals in Northern England. All the patients had undergone ICA for non-ST-elevation myocardial infarction acute coronary syndrome (ACS) and chronic coronary syndrome (CCS). Cardiologists’ management plans and confidence levels were noted after ICA and again after vFFR analysis.
The results showed that 517 patients were screened, and 320 were enrolled in this study (208 with ACS and 112 with CCS). Median vFFR was 0.82 (0.70-0.91). The vFFR didn’t change the average number of narrowed vessels per patient (1.16 (±0.96) visually and 1.18 (±0.92) with vFFR (P=0.79)). Following vFFR, management plans shifted for 22% of all patients; in ACS, more patients opted for medical management (62%), and in CCS, (31%) opted for percutaneous coronary intervention (PCI). Overall, vFFR increased physician confidence significantly ( from 8 to 10 (7.33-9) to 9 of 10 (8-10) (P<0.001).
Investigators concluded that adding vFFR to ICA altered management plans for 22% of patients, offered a comprehensive coronary artery disease assessment, and boosted operator confidence in treatment decisions.
Source: heart.bmj.com/content/early/2024/05/16/heartjnl-2024-324039
