6533b7dafe1ef96bd126e449

RESEARCH PRODUCT

Factors affecting short- and long-term survival of patients with acute coronary syndrome treated invasively using intravascular ultrasound and fractional flow reserve: Analysis of data from the Polish Registry of Acute Coronary Syndromes 2017-2020

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Background: Intravascular ultrasound (IVUS) and fractional flow reserve (FFR) are invasive procedures increasingly used in acute coronary syndrome (ACS). Aims: The aim of this study was to evaluate the prevalence of IVUS and FFR use in patients with ACS in Poland and to assess the safety of these procedures, as well as their impact on short- and long-term survival. Methods and results: The retrospective study included 103849 patients enrolled in the PL-ACS registry in 2017-2020. IVUS was performed in 1,727 patients, FFR in 1,537 patients, both procedures in 37 patients. The frequency of performing FFR in ACS over the years increased from 1.3% to 1.8% (p <0.0001) and IVUS from 1.7% to 2.3% (p <0.0001). In the FFR and/or IVUS group, a similar incidence of stroke, reinfarction, target vessel revascularization and major bleeding was observed, while in-hospital mortality was lower (0% for IVUS + FFR vs. 0.9% for FFR vs. 2.3% for IVUS vs. 3.7 for no procedure; p <0.0001). FFR and IVUS did not affect the 30-day and one-year prognosis. Conclusion: In the consequent years, the number of FFR and IVUS procedures performed in patients with ACS in Poland increased. There was lower in-hospital mortality in the FFR and/or IVUS group in ACS, no differences in the incidence of stroke, reinfarction, target vessel revascularization and major bleeding were observed. Performing FFR and IVUS in ACS does not significantly affect 30-day or one-year mortality.