Introduced in early 2000, Fractional Flow Reserve (FFR) was initially validated for deferring percutaneous coronary intervention (PCI) when>0.80. After September 2012, FAME2 suggested performing PCI when FFR<0.80. The impact of the two indications on routine practice is poorly documented.

Rate and indications of FFR use and decision for PCI was assessed monthly between April 1999 and Sept 2014 in a single center.

We calculated monthly the rates of FFR, coronary angiography (CA) and PCI.

Cumulative curves for CA, PCI and FFR we determined the according to time elapsed since 1999.

In a single center, 26629 CA, 12270 PCI and 2454 FFR were performed between 1999 and 2014. Monthly rates were 182 CA, 77 PCI and 14 FFR. The cumulative curves showed that the rates of CA and PCI were stable, with a near-perfect linear correlation for each time interval. Conversely, there was a change in the rate of FFR, the best spline point for the FFR use was found in September 2012. From 1999 to Sept 2012, the rate of FFR was 14/month and increased to 21/month after Sept 2012. There was no significant difference in the patient characteristics, indications for CA or center team or equipment between the 2 periods, but the rate of FFR/CA increased from 7.3 to 12%.

Physicians performed more FFR after Sept 2012. This increase in routine use of FFR was only explained by the additional indication for FFR resulting from the publication of the FAME2 study.