Impact of post-percutaneous coronary intervention fractional flow reserve measurement on procedural management and clinical outcomes: The REPEAT-FFR study

Lorenzo Azzalini, Enrico Poletti, Ozan M. Demir, Marco B. Ancona, Antonio Mangieri, Francesco Giannini, Mauro Carlino, Alaide Chieffo, Matteo Montorfano, Antonio Colombo, Azeem Latib

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Objective. We evaluated the impact of post-percutaneous coronary intervention (PCI) fractional flow reserve (FFR) in a prospective study. Methods. This was a single-center, prospective registry of patients undergoing PCI following a baseline FFR =0.80. Patients were divided according to the post-PCI FFR value (<0.90 vs ≥0.90). The primary endpoint was the proportion of cases in which further action was undertaken in light of a post-PCI FFR value <0.90. Results. Of 65 PCIs, a total of 43 (66%) had a post-PCI FFR <0.90 and 22 (34%) had a post-PCI FFR ≥0.90. Baseline characteristics were similar between groups. Baseline FFR was similar between patients with post-PCI FFR <0.90 and =0.90 (0.72 ± 0.08 vs 0.69 ± 0.14; P=.40). Post-PCI FFR values were 0.82 ± 0.05 in post-PCI FFR <0.90 patients and 0.94 ± 0.02 in post-PCI FFR =0.90 patients (P<.001). The most common reason for a post-PCI <0.90 was residual small-vessel disease (42%). In 15 patients (35%) with a post-PCI FFR <0.90, an action was undertaken. An increase of 0.05 ± 0.07 in FFR value (P=.01) was noted after these maneuvers. However, a final FFR value ≥0.90 was achieved in only 3 patients (20%). The major adverse cardiac event (MACE) rate at 1-year follow-up was higher in patients with final FFR <0.90 (31.6% vs 9.1%; P=.047). Conclusions. A suboptimal physiologic outcome is observed in two-thirds of patients undergoing PCI. Despite further interventions, a satisfactory outcome is achieved in only a minority of cases. A post-PCI suboptimal physiologic outcome appears to be associated with a higher incidence of MACE at follow-up.

Original languageEnglish (US)
Pages (from-to)229-234
Number of pages6
JournalJournal of Invasive Cardiology
Volume31
Issue number8
StatePublished - 2019
Externally publishedYes

Keywords

  • Coronary physiology
  • Fractional flow reserve
  • Percutaneous coronary intervention

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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