title: Utility of myocardial fractional flow reserve for prediction of restenosis following sirolimus-eluting stent implantation.
abstract: Drug-eluting stents reduce restenosis due to neointimal growth suppression. Considering long-term outcomes, it is both difficult and important to predict drug-eluting stent restenosis. Thus, this study was designed to examine the utility of myocardial fractional flow reserve (FFR) as a predictor of sirolimus-eluting stent (SES) restenosis. Thirty-three patients (35 lesions) were enrolled. Upon completion of SES implantation, FFR was obtained under hyperemia. At 8 months of follow-up, coronary angiography revealed that five lesions had restenosis. Percent diameter stenosis (restenosis 68.7 ± 12.8% vs. non-restenosis 68.7 ± 12.4%, p = 0.78) and lesion length (restenosis 15.8 ± 9.4 mm vs. non-restenosis 14.4 ± 9.2 mm, p = 0.60) were similar. At post-intervention, percent diameter stenosis (restenosis 16.4 ± 6.1% vs. non-restenosis 14.0 ± 7.4%, p = 0.48) and minimum stent area (restenosis 6.01 ± 1.08 mm2 vs. non-restenosis 6.27 ± 1.85 mm2, p = 0.92) were also equivalent. However, proximal edge lumen area was smaller (restenosis 4.24 ± 1.40 mm2 vs. non-restenosis 7.73 ± 2.64 mm2, p = 0.004) and FFR was lower in the restenosis group (restenosis 0.81 ± 0.12 vs. non-restenosis 0.92 ± 0.06, p = 0.029). SES patients with restenosis had a lower FFR post stent deployment, suggesting the decreased FFR may be a useful predictor for SES restenosis.
authors.affiliation: Department of Cardiology, Higashisumiyoshi Morimoto Hospital, Osaka, Japan.
authors.forename: Hideshi
authors.initials: H
authors.lastname: Ishii
authors.forename: Toru
authors.initials: T
authors.lastname: Kataoka
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Takara
authors.initials: T
authors.lastname: Tsumori
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Takeshita
authors.forename: Ryo
authors.initials: R
authors.lastname: Matsumoto
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Shirai
authors.forename: Hiroki
authors.initials: H
authors.lastname: Nishioka
authors.forename: Takao
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Shinji
authors.initials: S
authors.lastname: Nakata
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Shimada
authors.forename: Shoichi
authors.initials: S
authors.lastname: Ehara
authors.forename: Takashi
authors.initials: T
authors.lastname: Muro
authors.forename: Minoru
authors.initials: M
authors.lastname: Yoshiyama
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000295:instrumentation*; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D023921:Coronary Stenosis / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D054855:Drug-Eluting Stents; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D018570:Risk Assessment; D012307:Risk Factors; D020123:Sirolimus / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D002317:Cardiovascular Agents; D020123:Sirolimus