title: Clinical Relevance of Poststent Fractional Flow Reserve After Drug-Eluting Stent Implantation.
abstract: BACKGROUND
  The prognostic value of poststent fractional flow reserve (FFR) has not been clearly defined in patients with drug-eluting stent (DES) implantation. This study sought to evaluate the association between FFR and clinical outcomes after DES implantation with intravascular ultrasound (IVUS) assistance.
  
  
  METHODS
  A total of 115 lesions (107 patients) with FFR measurement after IVUS-assisted DES implantation were enrolled. Poststent angiographic and IVUS parameters were compared with FFR values. Clinical outcomes were assessed by target vessel failure (TVF), defined as a composite of target vessel revascularization, death, or non-fatal myocardial infarction attributed to the target vessel.
  
  
  RESULTS
  Mean poststent FFR was 0.92 ± 0.04. Minimal stent area by IVUS had a positive correlation with poststent FFR (r = 0.36; P<.01). Poststent FFR ≥0.89 was a physiologic cut-off value for 1-year TVF-free survival. The best cut-off value of minimal stent area to define poststent FFR ≥0.89 was >5.4 mm² (sensitivity, 63.2%; specificity, 90.0%). At 3-year follow-up, lesions with poststent FFR ≥0.89 had a better TVF-free survival rate than those with poststent FFR <0.89 (89.3% vs 61.1%, P =.03).
  
  
  CONCLUSIONS
  Poststent FFR can be a useful predictor for long-term clinical outcomes after DES implantation and relevant to IVUS minimal stent area.
authors.forename: Joon-Hyung
authors.initials: JH
authors.lastname: Doh
authors.forename: Chang-Wook
authors.initials: CW
authors.lastname: Nam
authors.affiliation: Seoul National University College of Medicine, 101 Daehang-ro, Chongno-gu, Seoul 110-744, Korea. bkkoo@snu.ac.kr or bkk1214@gmail.com.
authors.forename: Bon-Kwon
authors.initials: BK
authors.lastname: Koo
authors.forename: Sung Yun
authors.initials: SY
authors.lastname: Lee
authors.forename: Hyunmin
authors.initials: H
authors.lastname: Choi
authors.forename: June
authors.initials: J
authors.lastname: Namgung
authors.forename: Sung Uk
authors.initials: SU
authors.lastname: Kwon
authors.forename: Jae-Jin
authors.initials: JJ
authors.lastname: Kwak
authors.forename: Hyung-Yoon
authors.initials: HY
authors.lastname: Kim
authors.forename: Won-Ho
authors.initials: WH
authors.lastname: Choi
authors.forename: Won Ro
authors.initials: WR
authors.lastname: Lee
mesh_terms: D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D053805:Fractional Flow Reserve, Myocardial / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011184:Postoperative Period; D015203:Reproducibility of Results; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional