1.Differential Prognostic Implications of Pre- and Post-Stent Fractional Flow Reserve in Patients Undergoing Percutaneous Coronary Intervention
Jinlong ZHANG ; 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
Korean Circulation Journal 2022;52(1):47-59
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.
Result Analysis
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