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Angiographic Findings and Post-Percutaneous Coronary Intervention Fractional Flow Reserve

Jinlong Zhang1, Doyeon Hwang2, Seokhun Yang2

  • 1Department of Cardiology, Second Affiliated Hospital of Zhejiang University School of Medicine, State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China.

JAMA Network Open
|June 21, 2024
PubMed

Insights

Angiographic findings poorly correlate with post-percutaneous coronary intervention (PCI) fractional flow reserve (FFR). Post-PCI FFR, not angiographic measures, predicts target vessel failure, supporting its use as a quality metric.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Medical Imaging

Background:

  • The relationship between angiographic results and functional assessment (FFR) after PCI is not fully understood.
  • Residual functional disease burden after stenting impacts clinical outcomes.

Purpose of the Study:

  • To assess the association between angiographic parameters and post-PCI FFR.
  • To evaluate the clinical relevance of residual functional disease burden after drug-eluting stent implantation.

Main Methods:

  • A cohort study of 2147 patients from the International Post-PCI FFR registry.
  • Patients were grouped by post-PCI FFR: residual ischemia (≤0.80), suboptimal (0.81-0.86), and optimal (>0.86).
  • Primary outcome was target vessel failure (TVF) at 2 years.

Main Results:

  • Angiographic parameters showed poor correlation with post-PCI FFR (r < 0.20).
  • Post-PCI FFR, but not angiographic parameters, was associated with TVF.
  • Residual ischemia group had significantly higher TVF rates compared to suboptimal and optimal groups.

Conclusions:

  • Low association exists between angiographic findings and post-PCI FFR.
  • Post-PCI FFR is a predictor of clinical events, unlike angiographic parameters alone.
  • Post-PCI FFR should be considered a procedural quality metric.
Abstract

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