Abstract 14457: Influence of Post-Stent Fractional Flow Reserve and Stent Cross-sectional Area on Clinical Outcome in Patient Treated With Drug Eluting Stent
Objectives: We evaluated relationship and influence on the clinical outcome of physiologic and anatomic parameters after drug eluting stent (DES) implantation.
Background: Relationship and prognostic value between post-stent FFR (FFRpost) and IVUS derived minimal stent area (MSA) have been rarely evaluated in patient treated with DES.
Methods: 115 lesions in 107 patients who treated by DES and evaluated by IVUS and FFR examination at the end of index PCI procedure were enrolled. FFRpost≥0.9 was defined as physiologic threshold of optimal DES. Angiographic and IVUS parameters were compared according to higher (≥0.9) vs. lower (<0.9) FFRpost group. Influence of FFRpost and MSA on the MACE (composite of target vessel related death, non-fatal myocardial infarction, and revascularization) were estimated.
Results: Mean FFRpost was 0.92±0.04, and achieved in 86 lesions (74.8%). Functional performance of MSA defining FFRpost ≥0.9 was ≥5.8mm2 as best cut-off value by 58.1%, 82.8%, 90.4%, 40.0% and 63.4% of sensitivity, specificity, positive predictive value, negative predictive value, and accuracy, respectively.). During median follow-up period (865.4±563.7days), 12 MACE (11.2%) were occurred. There was no difference in MACE free survival rate among FFRpost ≥0.9 and FFRpost <0.9 lesions (adjusted HR 2.29, 95% CI = 0.60 - 8.65) with favorable trend in FFRpost ≥0.9 group (91.2% vs. 81.8%, p=0.15), and no determinant for MACE, with borderline value in FFRpost <0.9(p=0.07, 95%CI =0.04-1.15).
Conclusions: In patient treated by DES, post-stent FFR≥0.9 was relevant to IVUS MSA≥5.8mm2 for optimal stent deployment and appeared favorable influences in trend on clinical outcome. Post-intervention FFR may offer prognostic value as well as pre-intervention FFR.
- © 2013 by American Heart Association, Inc.