Diabetes mellitus and long-term safety of FFR and iFR-based coronary revascularization deferral

Diabetes mellitus and long-term safety of FFR and iFR-based coronary revascularization deferral

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ABSTRACT Introduction and objectives: The safety of physiology-based revascularization in patients with diabetes mellitus has been scarcely investigated.Our objective was to determine the safety of deferring revascularization based on the fractional flow 3 GRAIN PANCAKE MIX reserve (FFR) or the instantaneous wave-free ratio (iFR) in diabetic patients.Methods: Single-center, retrospective analysis of patients with intermediate coronary stenoses in whom revascularization was deferred based on FFR > 0.

80 or iFR > 0.89 values.The long-term rate of major adverse cardiovascular events, a composite of all-cause mortality, myocardial infarction, and target vessel revascularization (TVR), was assessed in diabetic and non-diabetic patients at the follow-up.

The rate of TVR based on the type of physiological index used to defer the lesion was also evaluated.Results: We evaluated 164 diabetic (214 vessels) and 280 non-diabetic patients (379 vessels).No significant differences in the rate of major adverse cardiovascular events was seen between diabetic and non-diabetic patients (20.

1% vs 13.2%; P =.245) at a median follow-up of 43 months.

All-cause mortality and cardiac death were not statistically different between both groups in the adjusted analysis (P >.05).A trend towards a higher rate of myocardial infarction was seen in diabetic patients (6.

7% vs 2.9%; P =.063).

However, the rate of target vessel myocardial infarction was similar in both groups (P =.874).Overall, TVR was similar in diabetics and non-diabetics (4.

7% vs 4.2%; P =.814); however, when Countertop Deep Fryers analyzed based on the physiological index, numerically, diabetics had a higher rate of TVR when the FFR was used in the decision-making process compared to when the iFR was used (6.

4% vs 0.0%; P =.064).

Conclusions: Deferring the revascularization of intermediate stenoses in patients with DM based on the FFR or the iFR is safe regarding the risk of TVR or target vessel myocardial infarction, with a rate of events at the long-term follow-up similar to that seen in non-diabetic patients.