Prognostic Implications of Post-Intervention Resting Pd/Pa and Fractional Flow Reserve in Patients With Stent Implantation
This study sought to investigate the prognostic implications of post–percutaneous coronary intervention (PCI) nonhyperemic pressure ratios compared with that of post-PCI fractional flow reserve (FFR). FFR measured after PCI has been shown to possess prognostic implications. However, the prognostic v...
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| Veröffentlicht in: | JACC. Cardiovascular interventions 2020-08, Vol.13 (16), p.1920-1933 |
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| creator | Shin, Doosup Lee, Seung Hun Lee, Joo Myung Choi, Ki Hong Hwang, Doyeon Lee, Hyun-Jong Jang, Ho-Jun Kim, Hyun Kuk Kwak, Jae-Jin Ha, Sang Jin Song, Young Bin Shin, Eun-Seok Doh, Joon-Hyung |
| description | This study sought to investigate the prognostic implications of post–percutaneous coronary intervention (PCI) nonhyperemic pressure ratios compared with that of post-PCI fractional flow reserve (FFR).
FFR measured after PCI has been shown to possess prognostic implications. However, the prognostic value of post-PCI nonhyperemic pressure ratios has not yet been clarified.
A total of 588 patients who underwent PCI with available both post-PCI FFR and resting distal coronary pressure-to-aortic pressure ratio (Pd/Pa) were analyzed. Post-PCI FFR and Pd/Pa were measured after successful angiographic stent implantation. The primary outcome was target vessel failure (TVF) up to 2 years, defined as a composite of cardiac death, target vessel–related myocardial infarction, and clinically driven target vessel revascularization. Prognosis of patients according to post-PCI Pd/Pa was compared with that of post-PCI FFR.
Despite angiographically successful PCI, 18.5% had post-PCI FFR ≤0.80 and 36.9% showed post-PCI Pd/Pa ≤0.92. In post-PCI Pd/Pa >0.92 group, 93.8% of patients showed post-PCI FFR >0.80. Conversely, 60.4% of patients showed post-PCI FFR >0.80 in post-PCI Pd/Pa ≤0.92 group. Although there was significant difference in TVF according to post-PCI FFR (≤0.80 vs. >0.80: 10.3% vs. 2.5%; p 0.92: 6.2% vs. 2.5%; p = 0.029), the reclassification ability of model for TVF was increased only with post-PCI FFR (net reclassification index 0.627; p = 0.003; integrated discrimination index 0.019; p = 0.015), but not with post-PCI Pd/Pa, compared with model including clinical factors. Compared with patients with post-PCI Pd/Pa >0.92, patients with post-PCI Pd/Pa ≤0.92 and FFR ≤0.80 had significantly higher risk of TVF (10.4% vs. 2.5%; adjusted hazard ratio: 4.204; 95% confidence interval: 1.521 to 11.618; p = 0.006); however, those with post-PCI Pd/Pa ≤0.92 but FFR >0.80 showed similar risk of TVF (3.5% vs. 2.5%; adjusted hazard ratio: 1.327; 95% confidence interval: 0.398 to 4.428; p = 0.645).
Over one-half of the patients with abnormal post-PCI Pd/Pa ≤0.92 showed post-PCI FFR >0.80. Compared with post-PCI FFR, post-PCI Pd/Pa showed limited reclassification ability for the occurrence of TVF. Among patients with abnormal post-PCI Pd/Pa, only patients with positive post-PCI FFR showed significantly higher risk of TVF than did those with post-PCI Pd/Pa >0.92. (Prognostic Perspective of Invasive Hyperemic and Non-Hyperemic Physiologic Indices Measu |
| doi_str_mv | 10.1016/j.jcin.2020.05.042 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2436399014</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1936879820312619</els_id><sourcerecordid>2436399014</sourcerecordid><originalsourceid>FETCH-LOGICAL-c400t-575ea21f404cec7531b9baf37d2bca464414fbe87fbf022e50a186f9ceab2a13</originalsourceid><addsrcrecordid>eNp9kE1P3DAQhq0KVD7aP9AD8pFLwthxviQuFerCSkhEsBJHy3HGW6-y9tbOUtFfj8PSHnvyaPy878y8hHxjkDNg1dUm32jrcg4ccihzEPwTOWVNXWV1BeVRqtuiypq6bU7IWYwbgAramn8mJwVvWCsadkr-dMGvnY-T1XS53Y1Wq8l6F6k3tEvtbOkmDC_o5i59xAS6Ne2Gq05R5Qa6CErPX2qki9H_nokZp9bRLjklXaTPdvpJn6ZUv49Qbnqf8YUcGzVG_PrxnpPV4sfq5i67f7hd3ny_z7QAmLKyLlFxZgQIjbouC9a3vTJFPfBeK1EJwYTpsalNb4BzLEGxpjKtRtVzxYpzcnmw3QX_a58OkFsbNY5pD_T7KLkoqqJtgYmE8gOqg48xoJG7YLcqvEoGco5cbuQcuZwjl1DKFHkSXXz47_stDv8kfzNOwPUBwHTki8Ugo07BaBxsQD3Jwdv_-b8BUe6Uog</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2436399014</pqid></control><display><type>article</type><title>Prognostic Implications of Post-Intervention Resting Pd/Pa and Fractional Flow Reserve in Patients With Stent Implantation</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Shin, Doosup ; Lee, Seung Hun ; Lee, Joo Myung ; Choi, Ki Hong ; Hwang, Doyeon ; Lee, Hyun-Jong ; Jang, Ho-Jun ; Kim, Hyun Kuk ; Kwak, Jae-Jin ; Ha, Sang Jin ; Song, Young Bin ; Shin, Eun-Seok ; Doh, Joon-Hyung</creator><creatorcontrib>Shin, Doosup ; Lee, Seung Hun ; Lee, Joo Myung ; Choi, Ki Hong ; Hwang, Doyeon ; Lee, Hyun-Jong ; Jang, Ho-Jun ; Kim, Hyun Kuk ; Kwak, Jae-Jin ; Ha, Sang Jin ; Song, Young Bin ; Shin, Eun-Seok ; Doh, Joon-Hyung</creatorcontrib><description>This study sought to investigate the prognostic implications of post–percutaneous coronary intervention (PCI) nonhyperemic pressure ratios compared with that of post-PCI fractional flow reserve (FFR).
FFR measured after PCI has been shown to possess prognostic implications. However, the prognostic value of post-PCI nonhyperemic pressure ratios has not yet been clarified.
A total of 588 patients who underwent PCI with available both post-PCI FFR and resting distal coronary pressure-to-aortic pressure ratio (Pd/Pa) were analyzed. Post-PCI FFR and Pd/Pa were measured after successful angiographic stent implantation. The primary outcome was target vessel failure (TVF) up to 2 years, defined as a composite of cardiac death, target vessel–related myocardial infarction, and clinically driven target vessel revascularization. Prognosis of patients according to post-PCI Pd/Pa was compared with that of post-PCI FFR.
Despite angiographically successful PCI, 18.5% had post-PCI FFR ≤0.80 and 36.9% showed post-PCI Pd/Pa ≤0.92. In post-PCI Pd/Pa >0.92 group, 93.8% of patients showed post-PCI FFR >0.80. Conversely, 60.4% of patients showed post-PCI FFR >0.80 in post-PCI Pd/Pa ≤0.92 group. Although there was significant difference in TVF according to post-PCI FFR (≤0.80 vs. >0.80: 10.3% vs. 2.5%; p < 0.001) and Pd/Pa (≤0.92 vs. >0.92: 6.2% vs. 2.5%; p = 0.029), the reclassification ability of model for TVF was increased only with post-PCI FFR (net reclassification index 0.627; p = 0.003; integrated discrimination index 0.019; p = 0.015), but not with post-PCI Pd/Pa, compared with model including clinical factors. Compared with patients with post-PCI Pd/Pa >0.92, patients with post-PCI Pd/Pa ≤0.92 and FFR ≤0.80 had significantly higher risk of TVF (10.4% vs. 2.5%; adjusted hazard ratio: 4.204; 95% confidence interval: 1.521 to 11.618; p = 0.006); however, those with post-PCI Pd/Pa ≤0.92 but FFR >0.80 showed similar risk of TVF (3.5% vs. 2.5%; adjusted hazard ratio: 1.327; 95% confidence interval: 0.398 to 4.428; p = 0.645).
Over one-half of the patients with abnormal post-PCI Pd/Pa ≤0.92 showed post-PCI FFR >0.80. Compared with post-PCI FFR, post-PCI Pd/Pa showed limited reclassification ability for the occurrence of TVF. Among patients with abnormal post-PCI Pd/Pa, only patients with positive post-PCI FFR showed significantly higher risk of TVF than did those with post-PCI Pd/Pa >0.92. (Prognostic Perspective of Invasive Hyperemic and Non-Hyperemic Physiologic Indices Measured After Percutaneous Coronary Intervention [PERSPECTIVEPCI]; NCT04265443)
[Display omitted]</description><identifier>ISSN: 1936-8798</identifier><identifier>EISSN: 1876-7605</identifier><identifier>DOI: 10.1016/j.jcin.2020.05.042</identifier><identifier>PMID: 32819481</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Arterial Pressure ; Cardiac Catheterization ; Coronary Angiography ; Coronary Artery Disease - diagnosis ; Coronary Artery Disease - physiopathology ; Coronary Artery Disease - therapy ; Coronary Vessels - physiopathology ; drug-eluting stent ; Female ; fractional flow reserve ; Fractional Flow Reserve, Myocardial ; Hemodynamics ; Humans ; Hyperemia - physiopathology ; Male ; Middle Aged ; nonhyperemic pressure ratio ; percutaneous coronary intervention ; Percutaneous Coronary Intervention - adverse effects ; Percutaneous Coronary Intervention - instrumentation ; Predictive Value of Tests ; prognosis ; Prospective Studies ; Registries ; Risk Assessment ; Risk Factors ; Seoul ; Stents ; Time Factors ; Treatment Outcome</subject><ispartof>JACC. Cardiovascular interventions, 2020-08, Vol.13 (16), p.1920-1933</ispartof><rights>2020 American College of Cardiology Foundation</rights><rights>Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-575ea21f404cec7531b9baf37d2bca464414fbe87fbf022e50a186f9ceab2a13</citedby><cites>FETCH-LOGICAL-c400t-575ea21f404cec7531b9baf37d2bca464414fbe87fbf022e50a186f9ceab2a13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jcin.2020.05.042$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32819481$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shin, Doosup</creatorcontrib><creatorcontrib>Lee, Seung Hun</creatorcontrib><creatorcontrib>Lee, Joo Myung</creatorcontrib><creatorcontrib>Choi, Ki Hong</creatorcontrib><creatorcontrib>Hwang, Doyeon</creatorcontrib><creatorcontrib>Lee, Hyun-Jong</creatorcontrib><creatorcontrib>Jang, Ho-Jun</creatorcontrib><creatorcontrib>Kim, Hyun Kuk</creatorcontrib><creatorcontrib>Kwak, Jae-Jin</creatorcontrib><creatorcontrib>Ha, Sang Jin</creatorcontrib><creatorcontrib>Song, Young Bin</creatorcontrib><creatorcontrib>Shin, Eun-Seok</creatorcontrib><creatorcontrib>Doh, Joon-Hyung</creatorcontrib><title>Prognostic Implications of Post-Intervention Resting Pd/Pa and Fractional Flow Reserve in Patients With Stent Implantation</title><title>JACC. Cardiovascular interventions</title><addtitle>JACC Cardiovasc Interv</addtitle><description>This study sought to investigate the prognostic implications of post–percutaneous coronary intervention (PCI) nonhyperemic pressure ratios compared with that of post-PCI fractional flow reserve (FFR).
FFR measured after PCI has been shown to possess prognostic implications. However, the prognostic value of post-PCI nonhyperemic pressure ratios has not yet been clarified.
A total of 588 patients who underwent PCI with available both post-PCI FFR and resting distal coronary pressure-to-aortic pressure ratio (Pd/Pa) were analyzed. Post-PCI FFR and Pd/Pa were measured after successful angiographic stent implantation. The primary outcome was target vessel failure (TVF) up to 2 years, defined as a composite of cardiac death, target vessel–related myocardial infarction, and clinically driven target vessel revascularization. Prognosis of patients according to post-PCI Pd/Pa was compared with that of post-PCI FFR.
Despite angiographically successful PCI, 18.5% had post-PCI FFR ≤0.80 and 36.9% showed post-PCI Pd/Pa ≤0.92. In post-PCI Pd/Pa >0.92 group, 93.8% of patients showed post-PCI FFR >0.80. Conversely, 60.4% of patients showed post-PCI FFR >0.80 in post-PCI Pd/Pa ≤0.92 group. Although there was significant difference in TVF according to post-PCI FFR (≤0.80 vs. >0.80: 10.3% vs. 2.5%; p < 0.001) and Pd/Pa (≤0.92 vs. >0.92: 6.2% vs. 2.5%; p = 0.029), the reclassification ability of model for TVF was increased only with post-PCI FFR (net reclassification index 0.627; p = 0.003; integrated discrimination index 0.019; p = 0.015), but not with post-PCI Pd/Pa, compared with model including clinical factors. Compared with patients with post-PCI Pd/Pa >0.92, patients with post-PCI Pd/Pa ≤0.92 and FFR ≤0.80 had significantly higher risk of TVF (10.4% vs. 2.5%; adjusted hazard ratio: 4.204; 95% confidence interval: 1.521 to 11.618; p = 0.006); however, those with post-PCI Pd/Pa ≤0.92 but FFR >0.80 showed similar risk of TVF (3.5% vs. 2.5%; adjusted hazard ratio: 1.327; 95% confidence interval: 0.398 to 4.428; p = 0.645).
Over one-half of the patients with abnormal post-PCI Pd/Pa ≤0.92 showed post-PCI FFR >0.80. Compared with post-PCI FFR, post-PCI Pd/Pa showed limited reclassification ability for the occurrence of TVF. Among patients with abnormal post-PCI Pd/Pa, only patients with positive post-PCI FFR showed significantly higher risk of TVF than did those with post-PCI Pd/Pa >0.92. (Prognostic Perspective of Invasive Hyperemic and Non-Hyperemic Physiologic Indices Measured After Percutaneous Coronary Intervention [PERSPECTIVEPCI]; NCT04265443)
[Display omitted]</description><subject>Aged</subject><subject>Arterial Pressure</subject><subject>Cardiac Catheterization</subject><subject>Coronary Angiography</subject><subject>Coronary Artery Disease - diagnosis</subject><subject>Coronary Artery Disease - physiopathology</subject><subject>Coronary Artery Disease - therapy</subject><subject>Coronary Vessels - physiopathology</subject><subject>drug-eluting stent</subject><subject>Female</subject><subject>fractional flow reserve</subject><subject>Fractional Flow Reserve, Myocardial</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Hyperemia - physiopathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>nonhyperemic pressure ratio</subject><subject>percutaneous coronary intervention</subject><subject>Percutaneous Coronary Intervention - adverse effects</subject><subject>Percutaneous Coronary Intervention - instrumentation</subject><subject>Predictive Value of Tests</subject><subject>prognosis</subject><subject>Prospective Studies</subject><subject>Registries</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Seoul</subject><subject>Stents</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>1936-8798</issn><issn>1876-7605</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1P3DAQhq0KVD7aP9AD8pFLwthxviQuFerCSkhEsBJHy3HGW6-y9tbOUtFfj8PSHnvyaPy878y8hHxjkDNg1dUm32jrcg4ccihzEPwTOWVNXWV1BeVRqtuiypq6bU7IWYwbgAramn8mJwVvWCsadkr-dMGvnY-T1XS53Y1Wq8l6F6k3tEvtbOkmDC_o5i59xAS6Ne2Gq05R5Qa6CErPX2qki9H_nokZp9bRLjklXaTPdvpJn6ZUv49Qbnqf8YUcGzVG_PrxnpPV4sfq5i67f7hd3ny_z7QAmLKyLlFxZgQIjbouC9a3vTJFPfBeK1EJwYTpsalNb4BzLEGxpjKtRtVzxYpzcnmw3QX_a58OkFsbNY5pD_T7KLkoqqJtgYmE8gOqg48xoJG7YLcqvEoGco5cbuQcuZwjl1DKFHkSXXz47_stDv8kfzNOwPUBwHTki8Ugo07BaBxsQD3Jwdv_-b8BUe6Uog</recordid><startdate>20200824</startdate><enddate>20200824</enddate><creator>Shin, Doosup</creator><creator>Lee, Seung Hun</creator><creator>Lee, Joo Myung</creator><creator>Choi, Ki Hong</creator><creator>Hwang, Doyeon</creator><creator>Lee, Hyun-Jong</creator><creator>Jang, Ho-Jun</creator><creator>Kim, Hyun Kuk</creator><creator>Kwak, Jae-Jin</creator><creator>Ha, Sang Jin</creator><creator>Song, Young Bin</creator><creator>Shin, Eun-Seok</creator><creator>Doh, Joon-Hyung</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20200824</creationdate><title>Prognostic Implications of Post-Intervention Resting Pd/Pa and Fractional Flow Reserve in Patients With Stent Implantation</title><author>Shin, Doosup ; Lee, Seung Hun ; Lee, Joo Myung ; Choi, Ki Hong ; Hwang, Doyeon ; Lee, Hyun-Jong ; Jang, Ho-Jun ; Kim, Hyun Kuk ; Kwak, Jae-Jin ; Ha, Sang Jin ; Song, Young Bin ; Shin, Eun-Seok ; Doh, Joon-Hyung</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-575ea21f404cec7531b9baf37d2bca464414fbe87fbf022e50a186f9ceab2a13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Arterial Pressure</topic><topic>Cardiac Catheterization</topic><topic>Coronary Angiography</topic><topic>Coronary Artery Disease - diagnosis</topic><topic>Coronary Artery Disease - physiopathology</topic><topic>Coronary Artery Disease - therapy</topic><topic>Coronary Vessels - physiopathology</topic><topic>drug-eluting stent</topic><topic>Female</topic><topic>fractional flow reserve</topic><topic>Fractional Flow Reserve, Myocardial</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Hyperemia - physiopathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>nonhyperemic pressure ratio</topic><topic>percutaneous coronary intervention</topic><topic>Percutaneous Coronary Intervention - adverse effects</topic><topic>Percutaneous Coronary Intervention - instrumentation</topic><topic>Predictive Value of Tests</topic><topic>prognosis</topic><topic>Prospective Studies</topic><topic>Registries</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Seoul</topic><topic>Stents</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shin, Doosup</creatorcontrib><creatorcontrib>Lee, Seung Hun</creatorcontrib><creatorcontrib>Lee, Joo Myung</creatorcontrib><creatorcontrib>Choi, Ki Hong</creatorcontrib><creatorcontrib>Hwang, Doyeon</creatorcontrib><creatorcontrib>Lee, Hyun-Jong</creatorcontrib><creatorcontrib>Jang, Ho-Jun</creatorcontrib><creatorcontrib>Kim, Hyun Kuk</creatorcontrib><creatorcontrib>Kwak, Jae-Jin</creatorcontrib><creatorcontrib>Ha, Sang Jin</creatorcontrib><creatorcontrib>Song, Young Bin</creatorcontrib><creatorcontrib>Shin, Eun-Seok</creatorcontrib><creatorcontrib>Doh, Joon-Hyung</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>JACC. Cardiovascular interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shin, Doosup</au><au>Lee, Seung Hun</au><au>Lee, Joo Myung</au><au>Choi, Ki Hong</au><au>Hwang, Doyeon</au><au>Lee, Hyun-Jong</au><au>Jang, Ho-Jun</au><au>Kim, Hyun Kuk</au><au>Kwak, Jae-Jin</au><au>Ha, Sang Jin</au><au>Song, Young Bin</au><au>Shin, Eun-Seok</au><au>Doh, Joon-Hyung</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic Implications of Post-Intervention Resting Pd/Pa and Fractional Flow Reserve in Patients With Stent Implantation</atitle><jtitle>JACC. Cardiovascular interventions</jtitle><addtitle>JACC Cardiovasc Interv</addtitle><date>2020-08-24</date><risdate>2020</risdate><volume>13</volume><issue>16</issue><spage>1920</spage><epage>1933</epage><pages>1920-1933</pages><issn>1936-8798</issn><eissn>1876-7605</eissn><abstract>This study sought to investigate the prognostic implications of post–percutaneous coronary intervention (PCI) nonhyperemic pressure ratios compared with that of post-PCI fractional flow reserve (FFR).
FFR measured after PCI has been shown to possess prognostic implications. However, the prognostic value of post-PCI nonhyperemic pressure ratios has not yet been clarified.
A total of 588 patients who underwent PCI with available both post-PCI FFR and resting distal coronary pressure-to-aortic pressure ratio (Pd/Pa) were analyzed. Post-PCI FFR and Pd/Pa were measured after successful angiographic stent implantation. The primary outcome was target vessel failure (TVF) up to 2 years, defined as a composite of cardiac death, target vessel–related myocardial infarction, and clinically driven target vessel revascularization. Prognosis of patients according to post-PCI Pd/Pa was compared with that of post-PCI FFR.
Despite angiographically successful PCI, 18.5% had post-PCI FFR ≤0.80 and 36.9% showed post-PCI Pd/Pa ≤0.92. In post-PCI Pd/Pa >0.92 group, 93.8% of patients showed post-PCI FFR >0.80. Conversely, 60.4% of patients showed post-PCI FFR >0.80 in post-PCI Pd/Pa ≤0.92 group. Although there was significant difference in TVF according to post-PCI FFR (≤0.80 vs. >0.80: 10.3% vs. 2.5%; p < 0.001) and Pd/Pa (≤0.92 vs. >0.92: 6.2% vs. 2.5%; p = 0.029), the reclassification ability of model for TVF was increased only with post-PCI FFR (net reclassification index 0.627; p = 0.003; integrated discrimination index 0.019; p = 0.015), but not with post-PCI Pd/Pa, compared with model including clinical factors. Compared with patients with post-PCI Pd/Pa >0.92, patients with post-PCI Pd/Pa ≤0.92 and FFR ≤0.80 had significantly higher risk of TVF (10.4% vs. 2.5%; adjusted hazard ratio: 4.204; 95% confidence interval: 1.521 to 11.618; p = 0.006); however, those with post-PCI Pd/Pa ≤0.92 but FFR >0.80 showed similar risk of TVF (3.5% vs. 2.5%; adjusted hazard ratio: 1.327; 95% confidence interval: 0.398 to 4.428; p = 0.645).
Over one-half of the patients with abnormal post-PCI Pd/Pa ≤0.92 showed post-PCI FFR >0.80. Compared with post-PCI FFR, post-PCI Pd/Pa showed limited reclassification ability for the occurrence of TVF. Among patients with abnormal post-PCI Pd/Pa, only patients with positive post-PCI FFR showed significantly higher risk of TVF than did those with post-PCI Pd/Pa >0.92. (Prognostic Perspective of Invasive Hyperemic and Non-Hyperemic Physiologic Indices Measured After Percutaneous Coronary Intervention [PERSPECTIVEPCI]; NCT04265443)
[Display omitted]</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>32819481</pmid><doi>10.1016/j.jcin.2020.05.042</doi><tpages>14</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Aged Arterial Pressure Cardiac Catheterization Coronary Angiography Coronary Artery Disease - diagnosis Coronary Artery Disease - physiopathology Coronary Artery Disease - therapy Coronary Vessels - physiopathology drug-eluting stent Female fractional flow reserve Fractional Flow Reserve, Myocardial Hemodynamics Humans Hyperemia - physiopathology Male Middle Aged nonhyperemic pressure ratio percutaneous coronary intervention Percutaneous Coronary Intervention - adverse effects Percutaneous Coronary Intervention - instrumentation Predictive Value of Tests prognosis Prospective Studies Registries Risk Assessment Risk Factors Seoul Stents Time Factors Treatment Outcome |
| title | Prognostic Implications of Post-Intervention Resting Pd/Pa and Fractional Flow Reserve in Patients With Stent Implantation |
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