LONG-TERM OUTCOMES OF FRACTIONAL FLOW RESERVE-GUIDED PCI IN PATIENTS WITH MULTIVESSEL DISEASE

Background: This study evaluates the long-term clinical results of patients receiving fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) for multivessel coronary artery disease (MVD). The functional relevance of coronary lesions is frequently overestimated by traditional angiography, which results in needless procedures. By treating only functionally important lesions, FFR, a physiological assessment, has become a more accurate tool for guiding PCI and increasing results. Methods: A total of 300 patients with multivessel disease (MVD) who underwent FFR-guided PCI between January 2021 and December 2022 were included in this retrospective cohort study. Patients were divided into two groups based on their FFR values: FFR >0.80 (n=150) and FFR ≤0.80 (n=150). Clinical outcomes—including all-cause mortality, myocardial infarction (MI), repeat revascularization, and major adverse cardiac events (MACE)—were monitored over a two-year follow-up period, extending through December 2024. Results: The FFR <0.80 group had a significantly higher rate of repeat revascularization and MACE compared to the FFR >0.80 group, although differences in all-cause mortality and MI did not reach statistical significance. Procedural analysis indicated greater disease complexity and more frequent multi-vessel interventions in the lower FFR group. The study supports existing literature, such as FAME and DEFER trials, highlighting the safety and economic benefits of deferring PCI in lesions with higher FFR values. The findings affirm the prognostic value of FFR, demonstrating its role in optimizing treatment plans and reducing unnecessary procedures. Conclusion: FFR-guided PCI enhances long-term outcomes in MVD by tailoring interventions to physiological lesion severity, emphasizing its value in clinical decision-making and health economics. Routine implementation of FFR in multivessel CAD is strongly supported.