Author + information
- Tetsumin Lee,
- Taishi Yonetsu,
- Tadashi Murai,
- Yoshihisa Kanaji,
- Eisuke Usui,
- Masahiro Hoshino and
- Tsunekazu Kakuta
Coronary flow reserve (CFR) is known to be the predictor of clinical outcome, even in lesions with normal fractional flow reserve (FFR). However, predictors of post-percutaneous coronary intervention (PCI) CFR is unclear.
We studied 260 lesions in 246 pts (1 lesion/vessel) who underwent both pre- and post-PCI FFR, CFR, index of microcirculatory resistance (IMR) measurement, and optical coherence tomography (OCT) with post-PCI FFR>0.80. Low CFR was defined as CFR<2.0 and lesions were divided into two groups; low-CFR (<2.0; n=54, 21%) and high-CFR (≥2.0; n=206, 79%). Lipid rich plaque (LRP) was defined as maximum lipid arc >180° by OCT. Patients with STEMI were excluded.
Of 260 lesions with 246 pts, 18% were male and 13% of pts were acute coronary syndrome. Post-PCI CFR were 3.32 (1st, 3rd quartile; 2.18, 5.12). In low-CFR group, patients were older, and more DM pts and left circumflex (LCX) lesions were found than in high-CFR (Table). Pre-PCI CFR was significantly lower in low-CFR group, whereas pre- and post-PCI FFR and pre-PCI IMR were similar between two groups (Table). In multivariable logistic regression analysis, older age, presence of diabetes mellitus (DM), LCX lesion, pre-PCI CFR, and LRP were independent predictors of post-PCI low-CFR.
In lesions with post-PCI FFR>0.80, 21% of lesions were low CFR and post-PCI low CFR was associated with older age, DM, LCX lesion, pre-PCI CFR, and LRP by OCT.
|Comparison between lesions with post-PCI low- and high-CFR|
|Total (n=260)||Post-PCI low-CFR (n=54)||Post-PCI high-CFR (n=206)||P|
|Pre-PCI FFR||0.76 (0.69, 0.80)||0.74 (0.68, 0.80)||0.77 (0.70, 0.81)||0.19|
|Pre-PCI CFR||2.43 (1.68, 3.52)||1.73 (1.37, 2.23)||2.78 (1.83, 3.91)||<0.001|
|Pre-PCI IMR||17.7 (13.3, 31.3)||22.1 (13.2, 32.2)||20.7 (13.4, 31.3)||0.95|
|Post-PCI FFR||0.89 (0.86, 0.94)||0.91 (0.86, 0.94)||0.89 (0.86, 0.94)||0.57|
|Lipid rich plaque by OCT||37.3%||51.9%||33.5%||0.02|
Poster Hall, Hall F
Sunday, March 17, 2019, 3:45 p.m.-4:30 p.m.
Session Title: Interventional Cardiology: IVUS and Intravascular Physiology 3
Abstract Category: 23. Interventional Cardiology: IVUS and Intravascular Physiology
Presentation Number: 1251-016
- 2019 American College of Cardiology Foundation