Abstract
Measuring fractional flow reserve (FFR) in percutaneous coronary intervention (PCI) has predictive value for PCI outcome. We decided to examine the utility of pre- and post-stenting FFR as a predictor of 6-month stent restenosis as well as MACE (major adverse cardiac events). Pre- and post-stenting FFR values were measured for 60 PCI patients. Within 6 months after stenting, all patients were followed for assessment of cardiac MACE including myocardial infarction, unstable angina, or positive exercise test. Stent restenosis was also assessed. Cut-off values for pre- and post-stenting FFR measurements were considered respectively as 0.65 and 0.92. Stent restenosis was detected in 4 patients (6.6%). All 4 patients (100%) with restenosis had pre-stenting FFR of < 0.65, while only 26 of 56 patients without restenosis (46.4%) had pre-stenting FFR value of < 0.65 (P = 0.039). Mean pre-stenting FFR in patients with restenosis was significantly lower than in those without restenosis (0.25 ± 0.01 vs. 0.53 ± 0.03, P = 0.022). Although stent restenosis was higher in patients with post-stenting FFR of < 0.92 (2 cases, 9.5%) than in those with FFR value of ≥ 0.92 (2 cases, 5.1%), the difference was not statistically (P = 0.510). Pre-stenting FFR, the use of longer stents, and history of diabetes mellitus can predict stent restenosis, but the value of post-stenting FFR for predicting restenosis was not explicit.
Highlights
Fractional flow reserve (FFR) is a useful technique used in coronary catheterization to measure pressure differences across a steno tic segment in a coronary artery (Pijls et al, 1996)
Cut-off values for pre- and post-stenting fractional flow reserve (FFR) measurements were considered respectively as 0.65 and 0.92.Stent restenosis was detected in 4 patients (6.6%)
In another study by Ishii et al, patients suffered from restenosis had a lower FFR at post stent deployment, suggesting the decreased FFR might be a useful predictor for stenting restenosis (Ishii et al, 2011)
Summary
Fractional flow reserve (FFR) is a useful technique used in coronary catheterization to measure pressure differences across a steno tic segment in a coronary artery (Pijls et al, 1996). FFR is basically defined as the pressure distal to a stenosis in a coronary vessel relative to the pressure before the stenosis. It can express the maximal flow down a vessel in the presence of a stenosis compared to the maximal flow in the hypothetical absence of the stenosis (Tonino et al, 2009). Some non-randomized studies suggested that patients who were treated based on FFR guidance had better outcome compared to those treated based on angiographic appearance alone (Wongpraparut et al, 2005; Legalery et al, 2005)
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