Predictors of postprocedural fractional flow reserve: Insights from the FFR-SEARCH study

Laurens J.C. van Zandvoort, Kaneshka Masdjedi, Tara Neleman, Maria Natalia Tovar Forero, Jeroen Wilschut, Wijnand Den Dekker, Roberto Diletti, Felix Zijlstra, Nicolas M. van Mieghem, Joost Daemen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Introduction and objectives: Patients with a low post-percutaneous coronary intervention (PCI) fractional flow reserve (FFR) are at a higher risk for future adverse cardiac events. The objective of the current study was to assess specific patient and procedural predictors of post-PCI FFR. Methods: The FFR-SEARCH study is a prospective single-center registry of 1000 consecutive all-comer patients who underwent FFR measurements after an angiographically successful PCI with a dedicated microcatheter. Mixed effects models were used to search for independent predictors of post-PCI FFR. Results: The mean post-PCI distal coronary pressure divided by the aortic pressure (Pd/Pa) was 0.96 ± 0.04 and the mean post-PCI FFR, 0.91 ± 0.07. After adjusting for the independent predictors of post-PCI FFR, the left anterior descending coronary artery as the measured vessel was the strongest predictor of post-PCI FFR (adjusted β = -0.063; 95%CI, -0.070 to -0.056; P <.0001) followed by the postprocedural minimum lumen diameter (adjusted β = 0.039; 95%CI, 0.015-0.065; P =.002). Additionally, male sex, in-stent restenosis, chronic total coronary occlusions, and pre- and post-dilatation were negatively associated with postprocedural FFR. Conversely, type A lesions, thrombus-containing lesions, postprocedural percent stenosis, and stent diameter were positively associated with postprocedural FFR. The R2 for the complete model was 53%. Conclusions: Multiple independent patient and vessel related predictors of postprocedural FFR were identified, including sex, the left anterior descending coronary artery as the measured vessel, and postprocedural minimum lumen diameter.

Original languageEnglish
Pages (from-to)91-97
Number of pages7
JournalREC: Interventional Cardiology
Volume3
Issue number2
DOIs
Publication statusPublished - 2021

Bibliographical note

FUNDING:
The FFR SEARCH study was conducted with institutional support from ACIST Medical Inc.

Publisher Copyright:
© 2020 Sociedad Española de Cardiología. Published by Permanyer Publications. This is an open access journal under the CC BY-NC-ND 4.0 license.

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