2026/09/29 13:16
Dr. Lu Zhongying, Department of Cardiology, National Taiwan University Branch, Hsinchu, explains the coronary artery photography and uses FFR for functional assessment, which can help doctors more accurately determine the condition of coronary artery stenosis and formulate appropriate treatment strategies for patients. (Provided by the hospital)
[Reporter Cai Changsheng/Hsinchu Report] Whether stent placement is necessary for the treatment of coronary heart disease is an issue of concern to clinicians and patients. The cardiology team at National Taiwan University Branch in Hsinchu used fractional coronary flow reserve (FFR)-guided treatment strategies to demonstrate the long-term safety and effectiveness of precision medical decision-making in real clinical scenarios. Based on the 6-year follow-up results of one patient, the team confirmed that drug treatment can stably control the disease and successfully avoid unnecessary stent implantation when the functional assessment is normal.
A 71-year-old male patient sought medical treatment for acute ST-segment ascending myocardial infarction in April 2019. At that time, he underwent left anterior descending artery stent implantation. Three months after discharge, another cardiac catheterization examination showed that the middle section of the right coronary artery was about 70% stenotic. The cardiology medical team of National Taiwan University Branch in Hsinchu further arranged for an FFR assessment and found that the value was 0.91, which is within the normal range.
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Based on the FFR results, the team assessed that the narrowed vessel had limited impact on myocardial blood flow, and decided to replace stent implantation with drug therapy, and continued to optimize treatment strategies such as antiplatelet, blood lipid lowering, and blood pressure control. Follow-up examinations until 2025 showed that the blood vessel condition was stable without significant deterioration. The patient did not develop angina symptoms and maintained good daily life functions.
FFR is currently an important indicator for evaluating whether coronary artery stenosis affects myocardial perfusion. By measuring the blood flow pressure difference in the blood vessel under maximum hyperemia, it provides functional information that is difficult to judge by angiography alone. When FFR is greater than 0.80, it means that the blood flow supply is sufficient and the patient can safely receive drug treatment.
The clinical experience of the Department of Cardiology, National Taiwan University Branch in Hsinchu shows that the introduction of FFR assessment can effectively avoid over-treatment, reduce unnecessary stent placement by approximately 30–40%, reduce patients’ implant-related risks, and also improve the overall efficiency of medical resource utilization.
The cardiology team at National Taiwan University Branch in Hsinchu emphasized that the purpose of accurate evaluation is not to deny stent treatment, but to choose the most appropriate treatment method for the patient. Optimal drug therapy plays a key role in the management of stable coronary heart disease, including antiplatelet drugs to prevent thrombosis, hypolipidemic drugs to stabilize arterial plaques, and control of blood pressure to reduce cardiac load, all of which help reduce the risk of long-term cardiovascular events.
Dr. Lu Zhongying from the Cardiovascular Department of National Taiwan University Branch in Hsinchu said that this long-term follow-up case clearly shows that the core of modern cardiac medicine is not "whether it can be done", but "whether it should be done". When the functional assessment results show that the blood flow supply is adequate, stable and safe treatment results can be achieved without the need for stent placement through complete drug treatment and tracking.
Lu Zhongying pointed out that stents are important and life-saving treatment tools, but doctors’ responsibility is to avoid unnecessary intervention and make every medical decision based on scientific evidence and the best interests of the patient.
