In patients over 60 years with FFR-guided deferred PCI, abnormal resting Pd/Pa increased the risk of vessel-oriented composite outcomes (HR 2.10; 95% CI 1.15-4.36; P=0.048).
Observational (n=1,134)
Yes
Does age influence the diagnostic performance and prognostic value of invasive pressure-based indices (FFR, Pd/Pa, CFR) in patients with coronary stenoses?
In older patients (>60 years) with deferred PCI based on FFR > 0.80, abnormal CFR and resting Pd/Pa provide incremental prognostic value for predicting adverse vessel-oriented outcomes.
Hazard Ratio: 2.1 (95% CI 1.15–4.36)
p-value: p=0.048
OBJECTIVES: Investigate age-related changes in coronary microvascular function, its effect on hyperemic and non-hyperemic indices of stenosis relevance, and its prognostic implications. BACKGROUND: Evidence assessing the effect of age on fractional flow reserve (FFR), resting mean distal intracoronary pressure/mean aortic pressure (Pd/Pa), and microcirculatory function remains scarce. METHODS: This is a post hoc study of a large prospective international registry (NCT03690713) including 1134 patients (1326 vessels) with coronary stenoses interrogated with pressure and flow guidewires. Age-dependent correlations with functional indices were analyzed. Prevalences of FFR, resting Pd/Pa, and coronary flow reserve (CFR) classification agreement were assessed. At 5 years follow-up, the relation between resting Pd/Pa, CFR, and their age-dependent implications on FFR-guided percutaneous coronary intervention (PCI) deferral (deferred if FFR > 0.80) were investigated using vessel-oriented composite outcomes (VOCO) composed of death, myocardial infarction, and repeated revascularization. RESULTS: Age correlated positively with FFR (r = 0.08, 95% confidence interval CI: 0.03 to 0.13, p = 0.005), but not with resting Pd/Pa (r = -0.03, 95% CI:-0.09 to 0.02, p = 0.242). CFR correlated negatively with age (r = -0.15, 95% CI: -0.21 to -0.10, p 0.80, CFR and resting Pd/Pa have an incremental value in predicting future vessel-oriented patient outcomes.
Faria et al. (2022) conducted an observational in Coronary stenoses (n=1,134). Abnormal resting Pd/Pa or abnormal CFR vs. Normal resting Pd/Pa or normal CFR was evaluated on Vessel-oriented composite outcomes (VOCO) composed of death, myocardial infarction, and repeated revascularization (HR 2.10, 95% CI 1.15 to 4.36, p=0.048). In patients over 60 years with FFR-guided deferred PCI, abnormal resting Pd/Pa increased the risk of vessel-oriented composite outcomes (HR 2.10; 95% CI 1.15-4.36; P=0.048).