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Angiography-derived fractional flow reserve versus coronary angiography to guide coronary artery bypass grafting in patients undergoing surgical valve procedures with concomitant coronary artery disea

3 hours ago
  • #Coronary Artery Disease
  • #Fractional Flow Reserve
  • #Cardiac Surgery
  • The FAVOR IV-QVAS trial compared angiography-derived fractional flow reserve (FFR) with coronary angiography to guide coronary artery bypass grafting (CABG) in patients undergoing valve surgery with concomitant coronary artery disease.
  • The study was a multicentre, triple-blind, randomised trial conducted in 12 tertiary hospitals in China.
  • Patients were randomly assigned to physiologically guided CABG (FFR ≤0.80) or anatomically guided CABG (stenosis diameter ≥50%).
  • Primary outcome was a composite of death, myocardial infarction, stroke, unplanned revascularisation, and new renal failure within 30 days post-surgery.
  • Key secondary outcome included the same events plus hospitalisation for unstable angina or heart failure at ≥1 year follow-up.
  • Results showed a significant reduction in the primary outcome in the FFR group (7.8%) vs. angiography group (13.4%).
  • At median follow-up of 27 months, the key secondary outcome was also lower in the FFR group (20.7% vs. 26.8%).
  • The study supports physiologically guided CABG using FFR for better clinical outcomes in valve surgery patients with coronary artery disease.