Fractional flow reserve or 3D-quantitative-coronary-angiography based vessel-FFR guided revascularization. Rationale and study design of the prospective randomized fast III trial

Alessandra Scoccia, Robert A. Byrne, Adrian P. Banning, Ulf Landmesser, Eric van Belle, Ignacio J. Amat-Santos, Manel Sabaté, Jan G. P. Tijssen, Ernest Spitzer, Joost Daemen

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2 Citations (Scopus)

Abstract

Background: Physiological assessment of intermediate coronary lesions to guide coronary revascularization is currently recommended by international guidelines. Vessel fractional flow reserve (vFFR) has emerged as a new approach to derive fractional flow reserve (FFR) from 3D-quantitative coronary angiography (3D-QCA) without the need for hyperemic agents or pressure wires. Study design and objectives: The FAST III is an investigator-initiated, open label, multicenter randomized trial comparing vFFR guided versus FFR guided coronary revascularization in approximately 2228 patients with intermediate coronary lesions (defined as 30%-80% stenosis by visual assessment or QCA). Intermediate lesions are physiologically assessed using on-line vFFR or FFR and treated if vFFR or FFR ≤0.80. The primary end point is a composite of all-cause death, any myocardial infarction, or any revascularization at 1-year post-randomization. Secondary end points include the individual components of the primary end point and cost-effectiveness will be investigated. Conclusions: FAST III is the first randomized trial to explore whether a vFFR guided revascularization strategy is non-inferior to an FFR guided strategy in terms of clinical outcomes at 1-year follow-up in patients with intermediate coronary artery lesions.
Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalAmerican Heart Journal
Volume260
DOIs
Publication statusPublished - 1 Jun 2023

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