Trial of Angiography versus pressure-Ratio Guided Enhancement Techniques - Fractional Flow Reserve - TARGET FFR
Contribution To Literature:
The TARGET FFR trial failed to show that a physiology-guided incremental optimization strategy was beneficial at improving the proportion of physiologically optimal PCI.
The goal of the trial was to evaluate a physiology-guided incremental optimization strategy compared with usual care among patients who underwent angiographically successful percutaneous coronary intervention (PCI).
After successful PCI, subjects underwent FFR of the target lesion. Subjects were randomized to a physiology-guided incremental optimization strategy versus a blinded control group. In the physiology-guided incremental optimization arm, PCI could be further optimized (post-dilatation) according to suboptimal FFR values.
- Total number of enrollees: 260
- Duration of follow-up: 1 year
- Mean patient age: 59 years
- Percentage female: 13%
- Percentage with diabetes: 19%
- Subjects who underwent angiographically successful PCI
Other salient features/characteristics:
Post-PCI (pre-randomization), the FFR value was ≥0.9 in 32%, 0.81-0.89 in 39%, and ≤0.8 in 29%.
The primary outcome, proportion of patients with FFR ≥0.9, was 38.1% in the physiology-guided incremental optimization group compared with 28.1% in the blinded control group (p = 0.099).
Secondary outcomes: The proportion of patients with FFR ≤0.8 was 18.6% in the physiology-guided incremental optimization group compared with 29.8% in the blinded control group (p = 0.045).
Among patients who underwent angiographically successful PCI, a physiology-guided incremental optimization strategy failed to improve the proportion of patients with an optimal result (i.e., FFR ≥0.9). A physiology-guided incremental optimization strategy was associated with a marginal decrease in suboptimal result (i.e., FFR ≤0.8).
Presented by Dr. Damien Collison at the Transcatheter Cardiovascular Therapeutics Virtual Meeting (TCT Connect), October 16, 2020.
Keywords: Angiography, Coronary Angiography, Dilatation, Fractional Flow Reserve, Myocardial, Myocardial Ischemia, Percutaneous Coronary Intervention, Physiology, TCT20, Transcatheter Cardiovascular Therapeutics
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