Author + information
- Mohammed Eid Madmani,
- Amjad Abualsuod,
- Mohan Edupuganti,
- Shiv Kumar Agarwal,
- Srikanth Kasula,
- Naga Venkata Pothineni,
- Ahmed Almomani,
- Jason Payne,
- Barry Uretsky and
- Abdul Hakeem
Background: Deferring PCI based on a non-ischemic FFR has been well established. Growing evidence suggests an increasingly important role of post-PCI FFR in outcome prediction. Whether the FFR value post-PCI contains the same prognostic weight as FFR in deferred lesions is not known.
Methods: Major adverse cardiac events (MACE) were compared between 547 patients in whom PCI was performed (and post-PCI FFR measured) and 576 patients in whom PCI was deferred based on a non-ischemic FFR. To account for significant differences in baseline differences between the two groups, a propensity matched cohort was analyzed with 340 patients in each group.
Results: The two groups were similar in baseline characteristics after propensity matching except for a higher proportion of diffuse disease in the PCI group. The median FFR with deferral was 0.87 and for post-PCI FFR was 0.88. During a median follow up of 3.2 years, there was no significant difference in MACE between the deferred and PCI groups (Figure). Similarly, across all FFR categories, the annualized MACE rate was similar between both groups. On Cox proportional hazards analysis for MACE, age (HR 1.02; 95% CI 1.007, 1.04), ACS (HR 1.7; 95% CI 1.3, 2.4), prior MI (HR 1.8; 95% CI 1.3, 2.4) and FFR (0.009; 955 CI 0.0006, 0.16) were independent predictors of MACE. There was no interaction between PCI (vs. deferral) and FFR for long-term MACE.
Conclusions: FFR value post-PCI carries the same prognostic significance as FFR value in deferred lesions.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Cardiology: Stent Failure Analysis by Intravascuar Imaging
Abstract Category: 23. Interventional Cardiology: IVUS and Intravascular Physiology
Presentation Number: 1193-137
- 2017 American College of Cardiology Foundation