Insufficient recovery of fractional flow reserve even after optimal implantation of drug-eluting stents: 3-year outcomes from the FUJI study

Yohei Hokama, Nobuhiro Tanaka, Hiroaki Takashima, Kazushige Kadota, Hiroshi Fujita, Michinao Tan, Ryotaro Yamada, Hiroyuki Naruse, Akio Kawamura, Nobuaki Suzuki, Tsuyoshi Takeuchi, Junichi Tazaki, Masaru Yamaki, Itaru Takamisawa, Shichiro Abe, Hidenobu Terai, Noriko Makiguchi, Chisa Matsumoto, Taishiro Chikamori

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Adequate improvement in fractional flow reserve (FFR) is not necessarily achieved in some cases of drug-eluting stent (DES) implantation, even when imaging confirms successful placement. We hypothesized that post-stent FFR may be associated with advanced diffuse atherosclerotic condition. We explored the relationships between FFR values after DES implantation (post-stent FFR). Methods: A total of 218 patients were included in this prospective, multicenter study and were divided into two groups: adequate FFR group (post-stent FFR >0.80, n=176) and inadequate FFR group (post-stent FFR ≤0.80, n=42). The primary endpoint was a major adverse cardiovascular event (MACE) including cardiac death, non-fatal myocardial infarction (MI), unplanned coronary revascularization, and hospitalization for heart failure. The secondary endpoints were event rate of all-cause death, non-fatal MI, unplanned coronary revascularization, non-fatal stroke, and hospitalization for heart failure. Results: During follow-up of 31.4±8.7 months, 34 patients (16%) had cardiovascular events. Inadequate FFR group was significantly associated with higher risk of MACE (hazard ratio: 3.86; 95% confidence interval: 1.17–12.76, p=0.026; log-rank p=0.027). In particular, the incidence of unplanned coronary revascularization on non-target lesions was significantly higher in the inadequate FFR group (log-rank p=0.031). Conclusions: Post-stent FFR ≤0.80 was associated with a high incidence of non-target lesion revascularization and could be a surrogate marker for advanced atherosclerotic condition in the vessels of the entire coronary artery.

Original languageEnglish
Pages (from-to)532-538
Number of pages7
JournalJournal of cardiology
Volume77
Issue number5
DOIs
Publication statusPublished - 05-2021

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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