title: Characterization of real-world patients with low fractional flow reserve immediately after drug-eluting stents implantation.
abstract: Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) for coronary artery disease has been validated. The present study aimed to identify the variables that influence FFR immediately after drug-eluting stents (DESs) implantation. We retrospectively analyzed 167 patients, who had been implanted with DESs at 6 Japanese institutions and had obtained the FFR values before and immediately after PCI. Intravascular ultrasound (IVUS) was used to build a PCI strategy and to decide the completion of the PCI procedure in all case. Patients were categorized into the following 2 groups according to FFR after PCI: the low FFR (≤0.80) group and the high FFR (>0.80) group. Despite successful PCI evaluated by coronary angiography and IVUS, 18.6 % of real-world patients were in the low FFR group. The proportion of the left anterior descending artery (LAD) was significantly greater in the low FFR group than in the high FFR group (87.1 vs 56.6 %; P < 0.01). Multivariate logistic regression analysis revealed that the LAD-to-non-LAD odds ratio for a low FFR (≤0.80) was 7.34 (95 % CI 1.63-32.95; P < 0.01) after adjustment for FFR value before PCI, suggesting that it is difficult to improve the hemodynamics of the LAD lesions even after successful PCI. The LAD was the strongest contributor to the inadequate recovery of FFR immediately after PCI, thus eliciting heed when treating the LAD lesions.
authors.affiliation: Department of Cardiology, Tokyo Medical University, 6-7-1, Nishi-Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan. yokimura@kt.rim.or.jp.
authors.forename: Yo
authors.initials: Y
authors.lastname: Kimura
authors.affiliation: Department of Cardiology, Tokyo Medical University, 6-7-1, Nishi-Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tanaka
authors.affiliation: Department of Cardiology, Kawasaki Medical School, Okayama, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okura
authors.affiliation: Department of Cardiology, Kawasaki Medical School, Okayama, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yoshida
authors.affiliation: Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Akabane
authors.affiliation: Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Tadateru
authors.initials: T
authors.lastname: Takayama
authors.affiliation: Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hirayama
authors.affiliation: Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Tada
authors.affiliation: Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kimura
authors.affiliation: Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Takano
authors.affiliation: Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Mizuno
authors.affiliation: Second Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Inami
authors.affiliation: Second Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yoshino
authors.affiliation: Department of Cardiology, Tokyo Medical University, 6-7-1, Nishi-Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Yamashina
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D062645:Percutaneous Coronary Intervention; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional
keywords: Drug-eluting stent; Fractional flow reserve; Intravascular ultrasound; Percutaneous coronary intervention; Target vessel