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Differential Prognostic Implications of Pre- and Post-Stent Fractional Flow Reserve in Patients Undergoing Percutaneous Coronary Intervention

Cited 4 time in Web of Science Cited 2 time in Scopus

Zhang, Jinlong; Hwang, Doyeon; Yang, Seokhun; 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

Issue Date
Korean Circulation Journal, Vol.52 No.1, pp.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 PER, 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 ofTVF 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 ofTVF 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 ofTVF 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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