Differential Prognostic Implications of Pre- and Post-Stent Fractional Flow Reserve in Patients Undergoing Percutaneous Coronary Intervention
- Author:
Jinlong ZHANG
1
;
Doyeon HWANG
;
Seokhun YANG
;
Chee Hae KIM
;
Joo Myung LEE
;
Chang-Wook NAM
;
Eun-Seok SHIN
;
Joon-Hyung DOH
;
Masahiro HOSHINO
;
Rikuta HAMAYA
;
Yoshihisa KANAJI
;
Tadashi MURAI
;
Jun-Jie ZHANG
;
Fei YE
;
Xiaobo LI
;
Zhen GE
;
Shao-Liang CHEN
;
Tsunekazu KAKUTA
;
Bon-Kwon KOO
Author Information
- Publication Type:Original Research
- From:Korean Circulation Journal 2022;52(1):47-59
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background and Objectives:The influence of pre-intervention coronary physiologic status on outcomes post percutaneous coronary intervention (PCI) is not well known. We sought to investigate the prognostic implications of pre-PCI fractional flow reserve (FFR) combined with post-PCI FFR.
Methods:A total of 1,479 PCI patients with pre-and post-PCI FFR data were analyzed. The patients were classified according to the median values of pre-PCI FFR (0.71) and post-PCI FFR (0.88). The primary outcome was target vessel failure (TVF) at 2 years.
Results:The risk of TVF was higher in the low pre-PCI FFR group than in the high pre-PCI FFR group (hazard ratio, 1.82; 95% confidence interval, 1.15–2.87; p=0.011). In 4 group comparisons, the cumulative incidences of TVF at 2 years were 3.8%, 4.1%, 4.8%, and 10.2% in the high pre-/high post-, low pre-/high post-, high pre-/low post-, and low pre-/low post-PCI FFR groups, respectively. The risk of TVF was the highest in the low pre-/low post-PCI FFR group among the groups (p values for comparisons <0.05). In addition, the high pre-/low post-PCI FFR group presented a comparable risk of TVF with the high post-PCI FFR groups (p values for comparison >0.05). When the prognostic value of the post-PCI FFR was evaluated according to the pre-PCI FFR, the risk of TVF significantly decreased with an increase in postPCI FFR in the low pre-PCI FFR group, but not in the high pre-PCI FFR group.
Conclusions:Pre-PCI FFR was associated with clinical outcomes after PCI, and the prognostic value of post-PCI FFR differed according to the pre-PCI FFR.
