Key result
A final fractional flow reserve < 0.95 after coronary stenting was a significant independent predictor of major adverse cardiac events at six months (OR 6.22; 95% CI 1.79-21.62; p=0.004).
Why the study?
Does a final fractional flow reserve (FFR) < 0.95 predict major adverse cardiac events after coronary stent implantation?
Cohort (n=119)
No
Does a final fractional flow reserve (FFR) < 0.95 predict major adverse cardiac events after coronary stent implantation?
Odds Ratio: 6.22 (95% CI 1.79–21.62)
p-value: p=0.004
A final FFR of < 0.95 after coronary stent implantation is a strong independent predictor of major adverse cardiac events at 6 months.
Should not yet change stenting practice; hypothesis-generating for FFR optimization in prospective trials.
OBJECTIVE: To determine the prognostic value of fractional flow reserve (FFR) measurements after coronary stent implantation including multiple clinical and angiographic parameters collected in one centre. METHODS: 119 consecutive patients were enrolled who had a stent implanted with the use of a pressure wire as a guidewire. Patients were followed up for at least six months. Any death, myocardial infarction, and target vessel revascularisation were considered major adverse cardiac events (MACE). Multivariate logistic regression was used to determine adjusted odds ratios (OR) and 95% confidence intervals (CI) for FFR and covariates. RESULTS: Complete follow up data were available for all 119 patients. Pre-interventional FFR increased from 0.65 (0.15) to 0.94 (0.06) (p < 0.0001) after stent implantation. Eighteen MACE (15%) occurred during follow up including 15 (12.6%) target vessel revascularisations. Final FFR was significantly higher in patients without than in patients with an event (0.95 (0.05) v 0.88 (0.08), p = 0.001). In the multivariate logistic regression analysis, only final FFR < 0.95 (OR 6.22, 95% CI 1.79 to 21.62, p = 0.004) and reduced left ventricular function (OR 0.95, 95% CI 092 to 0.99, p = 0.021) remained as significant independent predictors for MACE. CONCLUSION: These results including multiple parameters underline that FFR after coronary stenting is a strong and independent predictor for subsequent cardiac events after six months' follow up.
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Volker Klauß (2005) conducted a cohort in Coronary stent implantation (n=119). Final fractional flow reserve (FFR) < 0.95 vs. Final FFR ≥ 0.95 was evaluated on Major adverse cardiac events (death, myocardial infarction, and target vessel revascularisation) (OR 6.22, 95% CI 1.79 to 21.62, p=0.004). A final fractional flow reserve < 0.95 after coronary stenting was a significant independent predictor of major adverse cardiac events at six months (OR 6.22; 95% CI 1.79-21.62; p=0.004).
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