Author + information
- Suiji Li1,
- Shao-Liang Chen2,
- Zhen Ge3,
- Jing Kan3,
- Junjie Zhang4,
- Fei Ye5,
- Tak Kwan6,
- Teguh Santoso7,
- Song Yang8,
- Imad Sheiban9,
- Xue-Song Qian10,
- Nailiang Tian11,
- Tanveer Rab12 and
- Ling Tao13
- 1The First Hospital of Jintan City, Changzhou, China
- 2Nanjing First Hospital of Nanjing Medical Center, Nanjing, China
- 3Nanjing First Hospital of Nanjing Medical Center, Nanjing, Jiangsu, China
- 4Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
- 5Nanjing First Hospital, Nanjing Medical University, Nanjing, China, China
- 6Mount Sinai Beth Israel, New York, New York, United States
- 7Medistra Hospital, Jakarta, Indonesia
- 8Yixin people hospital, Yixin, Jiangsu, China
- 9Pederzoli Hospital-Peschiera del Garda (Verona)-Italy, Verona, Verona, Italy
- 10Zhangjiagang First People's Hospital, Jiangsu, China
- 11Nanjing First Hospital of Nanjing Medical Center, Nanjing, China
- 12Emory University Hospital, Atlanta, Georgia, United States
- 13The First Affiliated Hospital of The Fourth Military Medical University, Xian, Shanxi, China
FFR immediately after a DES implantation correlates with clinical events. However, the cutoff of post-DES FFR for predicting long-term clinical events remains understudied.
Between May 2012 and September 2013, a total of 1,476 patients who had FFR<0.8 at maximal and at baseline underwent DES implantation were prospectively studied in 9 centers. Post-DES FFR was repeat measured. The primary endpoint was the 1-year TVF rate after procedures. Receiver-operating characteristic curves were used to calculate the post-DES FFR value for TVF, then patients were classified on the basis of this value and followed up for 3 years.
By the end of the first year, 88 (6.0%) TVFs were recorded. A post-DES FFR ≤0.88 strongly correlated with TVF. Disease in the left anterior descending coronary artery (LAD), stent length, and stent diameter were independent factors of impaired post-DES FFR, whereas post-procedure FFR ≤0.88 was the only predictor of TVF, with 40 (4.0%) TVFs in the FFR >0.88 and 48 (8.0%) in the FFR ≤0.88 group (p = 0.001), mainly driven by target vessel revascularization (3.8% vs. 8.8%; p = 0.005) and cardiac death (0.2% vs. 1.3%; p = 0.017). The difference in TVF between 2 groups was maintained through 3-year follow-up (p = 0.002). For patients with LAD lesions, a post-DES FFR ≤0.905 predicted 1-year TVF.
Post-DES FFR strongly correlated with TVF rate. Mechanisms attributed to and treatments for impaired FFR after stenting should be studied in future studies.
CORONARY: PCI Outcomes