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KMID : 0368120220520010047
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Korean Circulation Journal
2022 Volume.52 No. 1 p.47 ~ p.59
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Differential Prognostic Implications of Pre- and Post-Stent Fractional Flow Reserve in Patients Undergoing Percutaneous Coronary Intervention
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Zhang Jinlong
Hwang Do-Yeon
Yang Seok-Hun
Kim Chee-Hae
Lee Joo-Myung
Nam Chang-Wook
Shin Eun-Seok
Doh Joon-Hyung
Hoshino Masahiro
Hamaya Rikuta
Kanaji Yoshihisa
Murai Tadashi
Zhang Jun-Jie
Ye Fei
Li Xiaobo
Ge Zhen
Chen Shao-Liang
Kakuta Tsunekazu
Koo Bon-Kwon
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Abstract
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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 post-PCI 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.
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KEYWORD
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Coronary artery disease, Percutaneous coronary intervention, Prognosis
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