Cutoff Value and Long-Term Prediction of Clinical Events by FFR Measured Immediately After Implantation of a Drug-Eluting Stent in Patients With Coronary Artery Disease: 1- to 3-Year Results From the DKCRUSH VII Registry Study

• Published in: JACC. Cardiovascular interventions 2017-05, Vol.10 (10), p.986-995
• Main Authors: Li, Sui-Ji, Ge, Zhen, Kan, Jing, Zhang, Jun-Jie, Ye, Fei, Kwan, Tak W, Santoso, Teguh, Yang, Song, Sheiban, Imad, Qian, Xue-Song, Tian, Nai-Liang, Rab, Tanveer S, Tao, Ling, Chen, Shao-Liang
• Format: Article
• Language: English
• Subjects: Aged; Area Under Curve; Cardiac Catheterization; Chi-Square Distribution; China; Coronary Angiography; Coronary Artery Disease - diagnosis; Coronary Artery Disease - physiopathology; Coronary Artery Disease - therapy; Coronary Vessels - diagnostic imaging; Coronary Vessels - physiopathology; Drug-Eluting Stents; Europe; Female; Fractional Flow Reserve, Myocardial; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - instrumentation; Predictive Value of Tests; Proportional Hazards Models; Prospective Studies; Registries; Risk Factors; ROC Curve; Time Factors; Tomography, Optical Coherence; Treatment Outcome; United States; Vasodilator Agents - administration & dosage
• ISSN: 1876-7605
• DOI: 10.1016/j.jcin.2017.02.012

This study aimed to investigate the cutoff of post-drug-eluting stent (DES) fractional flow reserve (FFR) for prediction of 1- to 3-year target vessel failure (TVF). 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 0.88 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. (Post-DES FFR Predicts the Clinical Outcomes: DK CRUSH-VII, A Prospective, Multicenter, Registry Study [DK CRUSH-VII]; ChiCTR-PRCH-12001976).