Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Choi, KH; Kwon, W; Shin, D; Lee, SH; Hwang, D; Zhang, J; Nam, CW; Shin, ES; Doh, JH; Chen, SL; Kakuta, T; Toth, GG; Piroth, Z; Hakeem, A; Uretsky, BF; Hokama, Y; Tanaka, N; Lim, HS; Ito, T; Matsuo, A; Azzalini, L; Leesar, MA; Daemen, J; Collison, D; Collet, C; De, Bruyne, B; Koo, BK; Park, TK; Yang, JH; Song, YB; Hahn, JY; Choi, SH; Gwon, HC; Lee, JM.
Differential Impact of Fractional Flow Reserve Measured After Coronary Stent Implantation by Left Ventricular Dysfunction.
JACC Asia. 2024; 4(3):229-240
Doi: 10.1016/j.jacasi.2023.10.009
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PubMed
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- Co-Autor*innen der Med Uni Graz
- Toth-Gayor Gabor
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- Abstract:
- BACKGROUND: Both left ventricular systolic function and fractional flow reserve (FFR) are prognostic factors after percutaneous coronary intervention (PCI). However, how these prognostic factors are inter-related in risk stratification of patients after PCI remains unclarified. OBJECTIVES: This study evaluated differential prognostic implication of post-PCI FFR according to left ventricular ejection fraction (LVEF). METHODS: A total of 2,965 patients with available LVEF were selected from the POST-PCI FLOW (Prognostic Implications of Physiologic Investigation After Revascularization with Stent) international registry of patients with post-PCI FFR measurement. The primary outcome was a composite of cardiac death or target-vessel myocardial infarction (TVMI) at 2 years. The secondary outcome was target-vessel revascularization (TVR) and target vessel failure, which was a composite of cardiac death, TVMI, or TVR. RESULTS: Post-PCI FFR was independently associated with the risk of target vessel failure (per 0.01 decrease: HRadj: 1.029; 95% CI: 1.009-1.049; P = 0.005). Post-PCI FFR was associated with increased risk of cardiac death or TVMI (HRadj: 1.145; 95% CI: 1.025-1.280; P = 0.017) among patients with LVEF ≤40%, and with that of TVR in patients with LVEF >40% (HRadj: 1.028; 95% CI: 1.005-1.052; P = 0.020). Post-PCI FFR ≤0.80 was associated with increased risk of cardiac death or TVMI in the LVEF ≤40% group and with that of TVR in LVEF >40% group. Prognostic impact of post-PCI FFR for the primary outcome was significantly different according to LVEF (Pinteraction = 0.019). CONCLUSIONS: Post-PCI FFR had differential prognostic impact according to LVEF. Residual ischemia by post-PCI FFR ≤0.80 was a prognostic indicator for cardiac death or TVMI among patients with patients with LVEF ≤40%, and it was associated with TVR among patients with patients with LVEF>40%. (Prognostic Implications of Physiologic Investigation After Revascularization with Stent [POST-PCI FLOW]; NCT04684043).