This study aimed to evaluate the predictive value of pre-interventional coronary CT angiography-derived fractional flow reserve (FFRCT) in chronic coronary syndrome (CCS) patients after percutaneous coronary intervention (PCI). Additionally, we investigated revascularization completeness using distal FFRCT (dFFRCT) and trans-lesion FFRCT gradient (ΔFFRCT). This prospective observational study included 475 patients who underwent CCTA within 90 days before PCI, among whom 97 patients experienced major adverse cardiovascular events (MACEs). Patients were stratified based on dFFRCT ≤ 0.80 and ΔFFRCT ≥ 0.22. Completeness of revascularization was assessed by integrating dFFRCT and ΔFFRCT. MACE was defined as a composite of cardiovascular death, spontaneous myocardial infarction, and target vessel revascularization. Kaplan-Meier curves were used to describe the cumulative incidence of MACEs. Both dFFRCT (HRadjust: 0.006, 95%CI: 0.001–0.057; P 0.80 (Log-rank: P < 0.001). The incomplete revascularization group, as assessed by both dFFRCT and ΔFFRCT, showed the highest risk of MACE (Log-rank: P < 0.001). ΔFFRCT effectively predicts MACEs in CCS patients after PCI. Integrating clinical features and hemodynamic characteristics enhances predictive accuracy. Additionally, ΔFFRCT aids in evaluating the completeness of revascularization.
Wang et al. (Sat,) studied this question.