{"id":"d0a43d26ae58","type":"article","url":"https://hartvaat.nl/2021/11/09/ffr-voor-behandeling-van-multivatencoronairlijden-jacc/","title":"FFR voor behandeling van multivatencoronairlijden: JACC","title_en":"Fractional Flow Reserve to Guide Treatment of Patients With Multivessel Coronary Artery Disease.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2021.08.061","source_url":"https://doi.org/10.1016/j.jacc.2021.08.061","authors":["Gilles Rioufol","François Dérimay","François Roubille","Thibault Perret","Pascal Motreff","Denis Angoulvant","Yves Cottin","Ludovic Meunier","Laura Cetran","Guillaume Cayla","Brahim Harbaoui","Jean-Yves Wiedemann","Éric Van Belle","Christophe Pouillot","Nathalie Noirclerc","Jean-François Morelle","François-Xavier Soto","Christophe Caussin","Bernard Bertrand","Thierry Lefèvre","Patrick Dupouy","Pierre-François Lesault","Franck Albert","Olivier Barthelemy","René Koning","Laurent Leborgne","Pierre Barnay","Philippe Chapon","Sébastien Armero","Antoine Lafont","Christophe Piot","Camille Amaz","Bernadette Vaz","Lakhdar Benyahya","Yvonne Varillon","Michel Ovize","Nathan Mewton","Gérard Finet"],"significance":6,"published":"2021-11-09","source_date":"2021-11-09","image":"","kennis":[],"congress":"","summary_en":"This analysis evaluated the role of FFR in guiding treatment strategy for multivessel coronary disease, assessing whether physiological assessment improves revascularization decisions in complex coronary anatomy.","created":"2026-07-03T10:29:29Z","updated":"2026-07-03T13:28:37Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"JACC analyse naar FFR-geleide behandeling van multivatencoronairlijden.","abstract_original":"BACKGROUND: There is limited evidence that fractional flow reserve (FFR) is effective in guiding therapeutic strategy in multivessel coronary artery disease (CAD) beyond prespecified percutaneous coronary intervention or coronary graft surgery candidates. OBJECTIVES: The FUTURE (FUnctional Testing Underlying coronary REvascularization) trial aimed to evaluate whether a treatment strategy based on FFR was superior to a traditional strategy without FFR in the treatment of multivessel CAD. METHODS: The FUTURE trial is a prospective, randomized, open-label superiority trial. Multivessel CAD candidates were randomly assigned (1:1) to treatment strategy based on FFR in all stenotic (≥50%) coronary arteries or to a traditional strategy without FFR. In the FFR group, revascularization (percutaneous coronary intervention or surgery) was indicated for FFR ≤0.80 lesions. The primary endpoint was a composite of major adverse cardiac or cerebrovascular events at 1 year. RESULTS: The trial was stopped prematurely by the data safety and monitoring board after a safety analysis and 927 patients were enrolled. At 1-year follow-up, by intention to treat, there were no significant differences in major adverse cardiac or cerebrovascular events rates between groups (14.6% in the FFR group vs 14.4% in the control group; hazard ratio: 0.97; 95% confidence interval: 0.69-1.36; P = 0.85). The difference in all-cause mortality was nonsignificant, 3.7% in the FFR group versus 1.5% in the control group (hazard ratio: 2.34; 95% confidence interval: 0.97-5.18; P = 0.06), and this was confirmed with a 24 months' extended follow-up. FFR significantly reduced the proportion of revascularized patients, with more patients referred to exclusively medical treatment (P = 0.02). CONCLUSIONS: In patients with multivessel CAD, we did not find evidence that an FFR-guided treatment strategy reduced the risk of ischemic cardiovascular events or death at 1-year follow-up. (Functional Testing Underlying Coronary Revascularisation; NCT01881555)."}