Coronary pressure measurement after stenting predicts adverse events at follow-up: a multicenter registry.
BACKGROUND
Coronary stenting is associated with a restenosis rate of 15% to 20% at 6-month follow-up, despite optimum angiographic stent implantation. In this multicenter registry, we investigated the relation between optimum physiological stent implantation as assessed by poststent fractional flow reserve (FFR) and outcome at 6 months.


RESULTS
In 750 patients, coronary pressure measurement at maximum hyperemia was performed after angiographically apparently satisfactory stent implantation. Poststenting FFR was calculated and related to major adverse events (including need for repeat target vessel revascularization) at 6 months. In 76 patients (10.2%), at least 1 adverse event occurred. Five patients died, 19 experienced myocardial infarction, and 52 underwent at least 1 repeat target vessel revascularization. By multivariate analysis, FFR immediately after stenting was the most significant independent variable related to all types of events. In 36% of the patients, FFR normalized (>0.95), and event rate was 4.9% in that group. In 32% of the patients, poststent FFR was between 0.90 and 0.95, and event rate was 6.2%. In 32% of patients, poststent FFR was <0.90, and event rate was 20.3%. In 6% of the patients, FFR was <0.80, and event rate was 29.5% (P<0.001).


CONCLUSIONS
FFR after stenting is a strong independent predictor of outcome at 6 months.
Pijls
Nico H J
NH
Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands. cardiologie.catharina.zks@wxs.nl
Klauss
Volker
V
Siebert
Uwe
U
Powers
Eric
E
Takazawa
Kenji
K
Fearon
William F
WF
Escaned
Javier
J
Tsurumi
Yukio
Y
Akasaka
Takashi
T
Samady
Habib
H
De Bruyne
Bernard
B
D001794:Blood Pressure; D003326:Coronary Circulation; D023903:Coronary Restenosis / Q000209:etiology / Q000503:physiopathology*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D012042:Registries; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome