Fractional flow reserve and quality-of-life improvement after percutaneous coronary intervention in patients with stable coronary artery disease

Takeshi Nishi, Zsolt Piroth, Bernard De Bruyne, Nikola Jagic, Sven Möbius-Winkler, Yuhei Kobayashi, François Derimay, Stephane Fournier, Emanuele Barbato, Pim Tonino, Peter Juni, Nico H.J. Pijls, William F. Fearon

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

BACKGROUND: Whether the benefit in quality of life (QOL) after percutaneous coronary intervention depends on the severity of the stenosis as determined by fractional flow reserve (FFR) remains unknown. This study sought to investigate the relationship between FFR values and improvement in QOL. METHODS: From the FAME 1 and 2 trials (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation), we identified 706 stable patients with coronary artery disease who had at least 1 lesion with an FFR≤0.80 that was treated with percutaneous coronary intervention and 185 patients with coronary artery disease who had no lesion with an FFR≤0.80 and were treated medically who served as a reference group. QOL was assessed by the European Quality of Life-5 Dimensions index at baseline, 1 month, and 1 year. We assessed the relationship between QOL improvement (defined as the change in European Quality of Life-5 Dimensions index from baseline) and FFR as a continuous value and according to abnormal FFR tertile. RESULTS: QOL improved significantly after percutaneous coronary intervention in each abnormal FFR tertile, whereas it did not change in the reference group. The lowest abnormal FFR subgroup had the greatest improvement in QOL at 1 month (P<0.001). In mixed-effects models for repeated measures, lower FFR (P=0.002 for 1 month and 0.049 for 1 year), greater delta FFR (P=0.021 for 1 month and 0.025 for 1 year), and higher angina class (P=0.001 for 1 month and < 0.001 for 1 year) were associated with the greatest magnitude of QOL improvement at both 1 month and 1 year. CONCLUSIONS: Among patients with stable coronary artery disease, FFR and angina severity predict QOL improvement after percutaneous coronary intervention.

Original languageEnglish (US)
Pages (from-to)1797-1804
Number of pages8
JournalCirculation
Volume138
Issue number17
DOIs
StatePublished - 2018
Externally publishedYes

Keywords

  • Fractional flow reserve
  • Myocardial
  • Percutaneous coronary intervention
  • Quality of life

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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