Clinical Outcomes in Patients with Deferred Coronary Lesions according to Disease Severity Assessed by Fractional Flow Reserve.
Data on the clinical outcomes in deferred coronary lesions according to functional severity have been limited. This study evaluated the clinical outcomes of deferred lesions according to fractional flow reserve (FFR) grade using Korean FFR registry data. Among 1,294 patients and 1,628 lesions in Korean FFR registry, 665 patients with 781 deferred lesions were included in this study. All participants were consecutively categorized into 4 groups according to FFR; group 1: ≥ 0.96 (n = 56), group 2: 0.86-0.95 (n = 330), group 3: 0.81-0.85 (n = 170), and group 4: ≤ 0.80 (n = 99). Primary endpoint was major adverse cardiac events (MACE), a composite of all-cause death, myocardial infarction, and target vessel revascularization. The median follow-up period was 2.1 years. During follow-up, the incidence of MACE in groups 1-4 was 1.8%, 7.6%, 8.8%, and 13.1%, respectively. Compared to group 1, the cumulative rate by Kaplan-Meier analysis of MACE was not different for groups 2 and 3. However, group 4 had higher cumulative rate of MACE compared to group 1 (log-rank P = 0.013). In the multivariate Cox hazard models, only FFR (hazard ratio [HR], 0.95; P = 0.005) was independently associated with MACE among all participants. In contrast, previous history of percutaneous coronary intervention (HR, 2.37; P = 0.023) and diagnosis of acute coronary syndrome (ACS) (HR, 2.35; P = 0.015), but not FFR, were independent predictors for MACE in subjects with non-ischemic (FFR ≥ 0.81) deferred coronary lesions. Compared to subjects with ischemic deferred lesions, clinical outcomes in subjects with non-ischemic deferred lesions according to functional severity are favorable. However, longer-term follow-up may be necessary.
Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Korea.|Division of Cardiology, Ulsan University Hospital, Ulsan, Korea.
Ki Bum
http://orcid.org/0000-0001-5502-9933
KB
Won
Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Korea. ncwcv@dsmc.or.kr.
Chang Wook
http://orcid.org/0000-0002-3370-5774
CW
Nam
Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Korea.
Yun Kyeong
http://orcid.org/0000-0002-0221-0971
YK
Cho
Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Korea.
Hyuck Jun
http://orcid.org/0000-0002-0563-7014
HJ
Yoon
Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Korea.
Hyoung Seob
http://orcid.org/0000-0002-8042-1029
HS
Park
Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Korea.
Hyungseop
http://orcid.org/0000-0001-7056-4221
H
Kim
Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Korea.
Seongwook
http://orcid.org/0000-0002-0496-7249
S
Han
Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Korea.
Seung Ho
http://orcid.org/0000-0002-3895-1915
SH
Hur
Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Korea.
Yoon Nyun
http://orcid.org/0000-0002-6315-0386
YN
Kim
Division of Cardiology, Eulji University Hospital, Daejeon, Korea.
Sang Hyun
http://orcid.org/0000-0001-7465-6772
SH
Park
Division of Cardiology, Seoul National University Hospital, Seoul, Korea.
Jung Kyu
http://orcid.org/0000-0002-0016-0747
JK
Han
Division of Cardiology, Seoul National University Hospital, Seoul, Korea.
Bon Kwon
http://orcid.org/0000-0002-8188-3348
BK
Koo
Division of Cardiology, Seoul National University Hospital, Seoul, Korea.
Hyo Soo
http://orcid.org/0000-0003-0847-5329
HS
Kim
Division of Cardiology, Inje University Ilsan Paik Hospital, Goyang, Korea.
Joon Hyung
http://orcid.org/0000-0001-7966-9564
JH
Doh
Division of Cardiology, Inje University Ilsan Paik Hospital, Goyang, Korea.
Sung Yun
http://orcid.org/0000-0001-5757-7706
SY
Lee
Division of Cardiology, Ajou University Medical Center, Suwon, Korea.
Hyoung Mo
http://orcid.org/0000-0003-3602-9772
HM
Yang
Division of Cardiology, Ajou University Medical Center, Suwon, Korea.
Hong Seok
http://orcid.org/0000-0002-3127-2071
HS
Lim
Division of Cardiology, Ajou University Medical Center, Suwon, Korea.
Myeong Ho
http://orcid.org/0000-0002-6412-8594
MH
Yoon
Division of Cardiology, Ajou University Medical Center, Suwon, Korea.
Seung Jea
http://orcid.org/0000-0001-6521-178X
SJ
Tahk
Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Korea.
Kwon Bae
http://orcid.org/0000-0003-0520-8321
KB
Kim
D054058:Acute Coronary Syndrome / Q000150:complications; D000368:Aged; D002423:Cause of Death; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000401:mortality / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D053805:Fractional Flow Reserve, Myocardial / Q000502:physiology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology; D009204:Myocardial Revascularization; D062645:Percutaneous Coronary Intervention; D016016:Proportional Hazards Models; D012042:Registries; D012720:Severity of Illness Index
Coronary Artery Disease; Fractional Flow Reserve; Prognosis