Circulation. 2002;105:2950-2954
Published online before print May 28, 2002, doi: 10.1161/01.CIR.0000020547.92091.76
Published online before print May 28, 2002, doi: 10.1161/01.CIR.0000020547.92091.76
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(Circulation. 2002;105:2950.)
© 2002 American Heart Association, Inc.
Clinical Investigation and Reports |
Coronary Pressure Measurement After Stenting Predicts Adverse Events at Follow-Up
A Multicenter Registry
From the Department of Cardiology (N.H.J.P.), Catharina Hospital, Eindhoven, the Netherlands; Klinikum Innenstadt (V.K.), München, Germany; Harvard Center for Risk Analysis (U.S.), Harvard School of Public Health, Boston, Mass; University of Virginia (E.P., H.S.), Charlottesville, Va; Tokyo Medical University (K.T.), Tokyo, Japan; Stanford University (W.F.F.), Stanford, Calif; San Carlos Hospital (J.E.), Madrid, Spain; Tokyo Women’s Medical University (Y.T.), Tokyo, Japan; Kawasaki Medical School (T.A.), Okayama, Japan; and Cardiovascular Center Aalst (B.D.B.), Belgium.
Correspondence to Nico H.J. Pijls, MD, PhD, Department of Cardiology, Catharina Hospital, PO Box 1350, 5602 ZA Eindhoven, The Netherlands. E-mail cardiologie.catharina.zks{at}wxs.nl
Background— Coronary stenting is associated with a restenosis rate of 15% to 20% at 6-month follow-up, despite optimum angiographic stent implantation. In this multicenter registry, we investigated the relation between optimum physiological stent implantation as assessed by poststent fractional flow reserve (FFR) and outcome at 6 months.
Methods and Results— In 750 patients, coronary pressure measurement at maximum hyperemia was performed after angiographically apparently satisfactory stent implantation. Poststenting FFR was calculated and related to major adverse events (including need for repeat target vessel revascularization) at 6 months. In 76 patients (10.2%), at least 1 adverse event occurred. Five patients died, 19 experienced myocardial infarction, and 52 underwent at least 1 repeat target vessel revascularization. By multivariate analysis, FFR immediately after stenting was the most significant independent variable related to all types of events. In 36% of the patients, FFR normalized (>0.95), and event rate was 4.9% in that group. In 32% of the patients, poststent FFR was between 0.90 and 0.95, and event rate was 6.2%. In 32% of patients, poststent FFR was <0.90, and event rate was 20.3%. In 6% of the patients, FFR was <0.80, and event rate was 29.5% (P<0.001).
Conclusions— FFR after stenting is a strong independent predictor of outcome at 6 months.
Key Words: blood flow • restenosis • stents
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