JACC. Cardiovascular interventions · 2025
Long-Term and Temporal Relationships Between Post-Stent Fractional Flow Reserve and Clinical Outcomes.
СтатьяНаблюдательное исследованиеМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Hwang Doyeon, Chung Jaewook, Yang Seokhun, Shin Eun-Seok, Nam Chang-Wook, Lee Hyun-Jong, Matsuo Hitoshi, Lee Joo Myung, Shiraishi Jun, Matsuo Akiko, Doh Joon-Hyung, Chen Shao-Liang, Kakuta Tsunekazu, Koo Bon-Kwon
Аннотация
BACKGROUND: Fractional flow reserve (FFR) following percutaneous coronary intervention (PCI) reflects the degree of flow limitation caused by residual disease after PCI.
OBJECTIVES: The aim of this study was to evaluate the long-term and temporal prognostic impact of post-PCI FFR on clinical outcomes over a 5-year follow-up period.
METHODS: A total of 2,128 patients who underwent angiographically successful drug-eluting stent implantation with post-PCI FFR measurement and completed 5 years of follow-up were analyzed. The primary outcome was target vessel failure (TVF), a composite of cardiac death, target vessel myocardial infarction, and target vessel revascularization (TVR).
RESULTS: The risk for TVF was higher in the low post-PCI FFR group than in the high post-PCI FFR group at 5 years (adjusted HR [aHR]: 1.95; 95% CI: 1.46-2.62; P < 0.001). The higher risk for TVF in the low post-PCI FFR group compared with the high post-PCI FFR group was prominent within 3 years after PCI (aHR: 2.00; 95% CI: 1.44-2.78; P < 0.001) and attenuated 3 years after PCI (aHR: 1.80; 95% CI: 0.94-3.44; P = 0.076). Contrary to other clinical outcomes, only TVR in the nonstented segment showed a higher risk in the low post-PCI FFR group compared with the high post-PCI within (aHR: 2.78; 95% CI: 1.43-5.39; P = 0.003) and beyond (aHR: 6.73; 95% CI: 2.02-22.37; P = 0.002) 3 years after PCI.
CONCLUSIONS: The prognostic impact of post-PCI FFR on TVF persisted over a 5-year follow-up period, but it was more prominent during the first 3 years after PCI. In contrast, its impact on TVR in the nonstented segments was sustained throughout the entire 5-year follow-up period. (International Post-PCI FFR Extended Registry; NCT05672862).
OBJECTIVES: The aim of this study was to evaluate the long-term and temporal prognostic impact of post-PCI FFR on clinical outcomes over a 5-year follow-up period.
METHODS: A total of 2,128 patients who underwent angiographically successful drug-eluting stent implantation with post-PCI FFR measurement and completed 5 years of follow-up were analyzed. The primary outcome was target vessel failure (TVF), a composite of cardiac death, target vessel myocardial infarction, and target vessel revascularization (TVR).
RESULTS: The risk for TVF was higher in the low post-PCI FFR group than in the high post-PCI FFR group at 5 years (adjusted HR [aHR]: 1.95; 95% CI: 1.46-2.62; P < 0.001). The higher risk for TVF in the low post-PCI FFR group compared with the high post-PCI FFR group was prominent within 3 years after PCI (aHR: 2.00; 95% CI: 1.44-2.78; P < 0.001) and attenuated 3 years after PCI (aHR: 1.80; 95% CI: 0.94-3.44; P = 0.076). Contrary to other clinical outcomes, only TVR in the nonstented segment showed a higher risk in the low post-PCI FFR group compared with the high post-PCI within (aHR: 2.78; 95% CI: 1.43-5.39; P = 0.003) and beyond (aHR: 6.73; 95% CI: 2.02-22.37; P = 0.002) 3 years after PCI.
CONCLUSIONS: The prognostic impact of post-PCI FFR on TVF persisted over a 5-year follow-up period, but it was more prominent during the first 3 years after PCI. In contrast, its impact on TVR in the nonstented segments was sustained throughout the entire 5-year follow-up period. (International Post-PCI FFR Extended Registry; NCT05672862).
Предметные рубрики MeSH
HumansFractional Flow Reserve, MyocardialMaleFemaleTime FactorsPercutaneous Coronary InterventionMiddle AgedTreatment OutcomeAgedCoronary Artery DiseaseRisk FactorsDrug-Eluting StentsCoronary AngiographyPredictive Value of TestsRegistriesCardiac CatheterizationRetrospective StudiesCoronary VesselsMyocardial InfarctionRisk Assessment