Details

Autor(en) / Beteiligte

• Ando, Hirohiko, MD
• Takashima, Hiroaki, MD
• Suzuki, Akihiro, MD
• Sakurai, Shinichiro, MD
• Kumagai, Soichiro, MD
• Kurita, Akiyoshi, MD
• Waseda, Katsuhisa, MD
• Amano, Tetsuya, MD

Titel

Impact of lesion characteristics on the prediction of optimal post-stent fractional flow reserve

Ist Teil von

• The American heart journal, 2016

Erscheinungsjahr

2016

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Background Post-stent fractional flow reserve (FFR) is a useful indicator of optimal percutaneous coronary intervention, and higher post-stent FFR is associated with favorable long-term clinical outcome. However, little is known about the factors influencing post-stent FFR. The purpose of this study was to determine the impact of lesion characteristics on post-stent FFR. Methods For patients that had scheduled stent implantation for stable angina, FFR measurements at maximum hyperemia were performed before and after coronary stent implantation. As one of lesion characteristics, the FFR pressure drop pattern was evaluated and classified as either an abrupt or a gradual pattern according to the pullback curve of FFR. Results A total of 205 lesions with physiological significant stenosis were evaluated. FFR value increased from 0.67 ± 0.10 to 0.87 ± 0.07 after stent implantation. Optimal post-stent FFR was achieved in 75 lesions (36.6%). Logistic regression analysis demonstrated that optimal post-stent FFR was positively correlated with an abrupt pressure drop pattern (hazard ratio [HR], 2.11; 95% confidence interval [CI], 1.06–4.15; P = .03) and pre-stent FFR (HR, 1.04; 95% CI, 1.03–2.04; P = .03; per 0.1 increase), and negatively correlated with lesion localization to the left anterior descending artery (HR, 0.18; 95% CI, 0.09–0.36; P < .0001). The C-statistic for predicting optimal post-stent FFR was 0.763 (95% CI, 0.702–0.819). Conclusion Abrupt pressure drop patterns, pre-stent FFR, and lesion localization to the left anterior descending artery were independent predictors of optimal post-stent FFR.