While application of a physiology-guided incremental optimization strategy (PIOS) did not significantly increase the proportion of patients achieving a final post-PCI fractional flow reserve (FFR) ≥0.90 by 20% as hypothesized, a PIOS strategy did significantly reduce the proportion of patients with final FFR ≤0.80, said investigators presenting TARGET FFR study results Oct. 16 during TCT 2020.

The single-center trial by Damien Collison, MD, et al., randomized 260 patients having undergone angiographically successful PCI procedures to either a PIOS intervention or a blinded control group. Of these patients, 32% had FFR ≥0.90 and 29% of patients had FFR ≤0.80.

Overall, the proportion of patients with final FFR ≥0.90 was 38.1% in the PIOS group and 28.1% in the control group for a 10% difference (P=0.099), missing the primary outcome of 20%. The proportion of patients with final FFR ≤0.80, however, was 18.6% in the PIOS group compared with 29.8% in the control group for an 11.2% difference (P=0.045). Additionally, researchers also noted that in the subset of 40 patients in the PIOS group, in whom further intervention/optimization was performed, final post-PCI FFR and CFR both increased significantly.

Clinical Topics: Invasive Cardiovascular Angiography and Intervention

Keywords: TCT20, Transcatheter Cardiovascular Therapeutics, Percutaneous Coronary Intervention, Fractional Flow Reserve, Myocardial

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