Abstract 16117: Delineating The Prognostic Value of Post PCI FFR in Acute Coronary Syndrome Patients

• Published in: Circulation (New York, N.Y.) N.Y.), 2019-11, Vol.140 (Suppl_1 Suppl 1), p.A16117-A16117
• Main Authors: Agarwal, Shiv Kumar, Vallurupalli, Srikanth, Siraj, Aisha, Rafeedheen, Rahil, Madmani, Mohammed Eid, Hasan, Rimsha, Ayan, Mohamed, Salehi, Negar, Kasula, Srikanth, Al-Hawwas, Malek, Hakeem, Abdul, Uretsky, Barry F
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.140.suppl_1.16117

BackgroundPost PCI FFR has prognostic value in both stable CAD and ACS patient population. It is accepted that higher post-PCI FFR leads to better outcomes in both groups. However, comparative data in these two groups with similar post-PCI FFR values is lacking.MethodsConsecutive patients undergoing PCI who had pre- and post-PCI FFR evaluations were followed for major adverse cardiovascular events (MACE) for 31±16 months. Outcomes were compared between stable ischemic heart disease (SIHD) and acute coronary syndrome (ACS) patients grouped into tertiles of post-PCI FFR.Results574 patients (SIHD=390 and ACS=184) were included215 (SIHD=149, ACS =66) in lowest tertile (FFR 0.92). MACE rate was 19% (109 patients) with 22.3%, 16.45 and 17.9% in lowest, mid and highest tertile respectively. Overall ACS patients had worse outcomes vs SIHD patients (HR 1.67, 95% CI 1.1- 2.5;p=0.007). MACE was similar in stable CAD and ACS in lowest (HR 1.5, 95% CI 0.78 to 2.72; P= 0.19) and highest (HR 1.05, 95% CI 0.51 to 2.17; p=0.89) tertiles. Among patients with post-PCI FFR in mid tertile ACS patients had higher MACE rates (HR 3.35, 95% CI 1.51 to 7.43; p=0.0005). (Figure)ConclusionsOverall prognosis of ACS is worse than SIHD. However, this difference can be negated by achieving a post PCI FFR >0.92. Outcomes in SIHD are comparable to ACS with suboptimal post PCI FFR(