The prognostic value of angiography-based vessel fractional flow reserve after percutaneous coronary intervention: The FAST Outcome study

Tara Neleman; Alessandra Scoccia; Kaneshka Masdjedi; Mariusz Tomaniak; Jurgen M.R. Ligthart; Karen T. Witberg; Alise Vermaire; Quinten Wolff; Leon Visser; Paul Cummins; Isabella Kardys; Jeroen Wilschut; Roberto Diletti; Wijnand K. Den Dekker; Felix Zijlstra; Nicolas M. Van Mieghem; Joost Daemen

doi:10.1016/j.ijcard.2022.04.021

The prognostic value of angiography-based vessel fractional flow reserve after percutaneous coronary intervention: The FAST Outcome study

Tara Neleman, Alessandra Scoccia, Kaneshka Masdjedi, Mariusz Tomaniak, Jurgen M.R. Ligthart, Karen T. Witberg, Alise Vermaire, Quinten Wolff, Leon Visser, Paul Cummins, Isabella Kardys, Jeroen Wilschut, Roberto Diletti, Wijnand K. Den Dekker, Felix Zijlstra, Nicolas M. Van Mieghem, Joost Daemen^*

^*Corresponding author for this work

Cardiology

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Background: Vessel Fractional Flow Reserve (vFFR) as assessed by three-dimensional quantitative coronary angiography has high correlation with pressure wire-based fractional flow reserve in both a pre- and post-PCI setting. The present study aims to assess the prognostic value of post-PCI vFFR on the incidence of target vessel failure (TVF), a composite endpoint of cardiac death, target vessel myocardial infarction and target vessel revascularization (TVR) at 5-year follow up. Methods: Post-PCI vFFR was calculated after routine PCI in a total of 748 patients (832 vessels) with available orthogonal angiographic projections of the stented segment. Results: Median age was 65 (IQR 55–74) years, 18.2% were diabetic, and 29.1% presented with stable angina. Median post-PCI vFFR was 0.91 (IQR 0.86–0.95). Vessels were categorized into tertiles based on post-PCI vFFR: low (vFFR <0.88), middle (vFFR 0.88–0.93), and upper (vFFR ≥0.94). Vessels in the lower and middle tertile were more often LADs and had smaller stent diameters (p<0.001). Vessels in the lower and middle tertile had a higher risk of TVF as compared to vessels in the upper tertile (24.6% and 21.5% vs. 17.1%; adjusted HR 1.84 (95%CI 1.15–2.95), p = 0.011, and 1.58 (95%CI 1.02–2.45), p = 0.040) at 5-years follow-up. Additionally, vessels in the lower tertile had higher rates of TVR as compared to vessels in the higher tertile (12.6% vs. 6.5%, adjusted HR 1.93 (95%CI 1.06–3.53), p = 0.033). Conclusion: Lower post-PCI vFFR values are associated with a significantly increased risk of TVF and TVR at 5-years follow-up.

Original language	English
Pages (from-to)	14-19
Number of pages	6
Journal	International Journal of Cardiology
Volume	359
Early online date	11 Apr 2022
DOIs	https://doi.org/10.1016/j.ijcard.2022.04.021
Publication status	Published - 15 Jul 2022

Bibliographical note

Funding Information:
Joost Daemen received institutional grant/research support from Astra Zeneca, Abbott Vascular, Boston Scientific, ACIST Medical, Medtronic, Pie Medical, and ReCor medical. Nicolas Van Mieghem has received institutional research grant support from Abbott Vascular, Boston Scientific, Edwards Lifesciences, Medtronic, Daiichi-Sankyo, PulseCath BV, and Abiomed. Tara Neleman received institutional grant support from Acist Medical Systems. Mariusz Tomaniak acknowledges funding as the laureate of the European Society of Cardiology Research and Training Program in the form of the ESC 2018 Grant (T-2018-19,628). Roberto Diletti reports institutional research grant to the Erasmus University Medical Center, consultant to ACIST Medical Systems. The remaining authors have nothing to disclose.

Funding Information:
Joost Daemen received institutional grant/research support from Astra Zeneca, Abbott Vascular , Boston Scientific , ACIST Medical, Medtronic, Pie Medical, and ReCor medical. Nicolas Van Mieghem has received institutional research grant support from Abbott Vascular , Boston Scientific , Edwards Lifesciences , Medtronic, Daiichi-Sankyo, PulseCath BV, and Abiomed. Tara Neleman received institutional grant support from Acist Medical Systems. Mariusz Tomaniak acknowledges funding as the laureate of the European Society of Cardiology Research and Training Program in the form of the ESC 2018 Grant (T-2018-19,628). Roberto Diletti reports institutional research grant to the Erasmus University Medical Center, consultant to ACIST Medical Systems. The remaining authors have nothing to disclose.

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© 2022 The Authors

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Neleman, T., Scoccia, A., Masdjedi, K., Tomaniak, M., Ligthart, J. M. R., Witberg, K. T., Vermaire, A., Wolff, Q., Visser, L., Cummins, P., Kardys, I., Wilschut, J., Diletti, R., Den Dekker, W. K., Zijlstra, F., Van Mieghem, N. M., & Daemen, J. (2022). The prognostic value of angiography-based vessel fractional flow reserve after percutaneous coronary intervention: The FAST Outcome study. International Journal of Cardiology, 359, 14-19. https://doi.org/10.1016/j.ijcard.2022.04.021

@article{a38df6989c464575828755e25deff268,

title = "The prognostic value of angiography-based vessel fractional flow reserve after percutaneous coronary intervention: The FAST Outcome study",

abstract = "Background: Vessel Fractional Flow Reserve (vFFR) as assessed by three-dimensional quantitative coronary angiography has high correlation with pressure wire-based fractional flow reserve in both a pre- and post-PCI setting. The present study aims to assess the prognostic value of post-PCI vFFR on the incidence of target vessel failure (TVF), a composite endpoint of cardiac death, target vessel myocardial infarction and target vessel revascularization (TVR) at 5-year follow up. Methods: Post-PCI vFFR was calculated after routine PCI in a total of 748 patients (832 vessels) with available orthogonal angiographic projections of the stented segment. Results: Median age was 65 (IQR 55–74) years, 18.2% were diabetic, and 29.1% presented with stable angina. Median post-PCI vFFR was 0.91 (IQR 0.86–0.95). Vessels were categorized into tertiles based on post-PCI vFFR: low (vFFR <0.88), middle (vFFR 0.88–0.93), and upper (vFFR ≥0.94). Vessels in the lower and middle tertile were more often LADs and had smaller stent diameters (p<0.001). Vessels in the lower and middle tertile had a higher risk of TVF as compared to vessels in the upper tertile (24.6% and 21.5% vs. 17.1%; adjusted HR 1.84 (95%CI 1.15–2.95), p = 0.011, and 1.58 (95%CI 1.02–2.45), p = 0.040) at 5-years follow-up. Additionally, vessels in the lower tertile had higher rates of TVR as compared to vessels in the higher tertile (12.6% vs. 6.5%, adjusted HR 1.93 (95%CI 1.06–3.53), p = 0.033). Conclusion: Lower post-PCI vFFR values are associated with a significantly increased risk of TVF and TVR at 5-years follow-up.",

author = "Tara Neleman and Alessandra Scoccia and Kaneshka Masdjedi and Mariusz Tomaniak and Ligthart, {Jurgen M.R.} and Witberg, {Karen T.} and Alise Vermaire and Quinten Wolff and Leon Visser and Paul Cummins and Isabella Kardys and Jeroen Wilschut and Roberto Diletti and {Den Dekker}, {Wijnand K.} and Felix Zijlstra and {Van Mieghem}, {Nicolas M.} and Joost Daemen",

note = "Funding Information: Joost Daemen received institutional grant/research support from Astra Zeneca, Abbott Vascular, Boston Scientific, ACIST Medical, Medtronic, Pie Medical, and ReCor medical. Nicolas Van Mieghem has received institutional research grant support from Abbott Vascular, Boston Scientific, Edwards Lifesciences, Medtronic, Daiichi-Sankyo, PulseCath BV, and Abiomed. Tara Neleman received institutional grant support from Acist Medical Systems. Mariusz Tomaniak acknowledges funding as the laureate of the European Society of Cardiology Research and Training Program in the form of the ESC 2018 Grant (T-2018-19,628). Roberto Diletti reports institutional research grant to the Erasmus University Medical Center, consultant to ACIST Medical Systems. The remaining authors have nothing to disclose. Funding Information: Joost Daemen received institutional grant/research support from Astra Zeneca, Abbott Vascular , Boston Scientific , ACIST Medical, Medtronic, Pie Medical, and ReCor medical. Nicolas Van Mieghem has received institutional research grant support from Abbott Vascular , Boston Scientific , Edwards Lifesciences , Medtronic, Daiichi-Sankyo, PulseCath BV, and Abiomed. Tara Neleman received institutional grant support from Acist Medical Systems. Mariusz Tomaniak acknowledges funding as the laureate of the European Society of Cardiology Research and Training Program in the form of the ESC 2018 Grant (T-2018-19,628). Roberto Diletti reports institutional research grant to the Erasmus University Medical Center, consultant to ACIST Medical Systems. The remaining authors have nothing to disclose. Publisher Copyright: {\textcopyright} 2022 The Authors",

year = "2022",

month = jul,

day = "15",

doi = "10.1016/j.ijcard.2022.04.021",

language = "English",

volume = "359",

pages = "14--19",

journal = "International Journal of Cardiology",

issn = "0167-5273",

publisher = "Elsevier Ireland Ltd",

}

Neleman, T, Scoccia, A, Masdjedi, K, Tomaniak, M , Ligthart, JMR , Witberg, KT, Vermaire, A, Wolff, Q, Visser, L, Cummins, P , Kardys, I, Wilschut, J, Diletti, R , Den Dekker, WK , Zijlstra, F , Van Mieghem, NM & Daemen, J 2022, 'The prognostic value of angiography-based vessel fractional flow reserve after percutaneous coronary intervention: The FAST Outcome study', International Journal of Cardiology, vol. 359, pp. 14-19. https://doi.org/10.1016/j.ijcard.2022.04.021

TY - JOUR

T1 - The prognostic value of angiography-based vessel fractional flow reserve after percutaneous coronary intervention

T2 - The FAST Outcome study

AU - Neleman, Tara

AU - Scoccia, Alessandra

AU - Masdjedi, Kaneshka

AU - Tomaniak, Mariusz

AU - Ligthart, Jurgen M.R.

AU - Witberg, Karen T.

AU - Vermaire, Alise

AU - Wolff, Quinten

AU - Visser, Leon

AU - Cummins, Paul

AU - Kardys, Isabella

AU - Wilschut, Jeroen

AU - Diletti, Roberto

AU - Den Dekker, Wijnand K.

AU - Zijlstra, Felix

AU - Van Mieghem, Nicolas M.

AU - Daemen, Joost

N1 - Funding Information: Joost Daemen received institutional grant/research support from Astra Zeneca, Abbott Vascular, Boston Scientific, ACIST Medical, Medtronic, Pie Medical, and ReCor medical. Nicolas Van Mieghem has received institutional research grant support from Abbott Vascular, Boston Scientific, Edwards Lifesciences, Medtronic, Daiichi-Sankyo, PulseCath BV, and Abiomed. Tara Neleman received institutional grant support from Acist Medical Systems. Mariusz Tomaniak acknowledges funding as the laureate of the European Society of Cardiology Research and Training Program in the form of the ESC 2018 Grant (T-2018-19,628). Roberto Diletti reports institutional research grant to the Erasmus University Medical Center, consultant to ACIST Medical Systems. The remaining authors have nothing to disclose. Funding Information: Joost Daemen received institutional grant/research support from Astra Zeneca, Abbott Vascular , Boston Scientific , ACIST Medical, Medtronic, Pie Medical, and ReCor medical. Nicolas Van Mieghem has received institutional research grant support from Abbott Vascular , Boston Scientific , Edwards Lifesciences , Medtronic, Daiichi-Sankyo, PulseCath BV, and Abiomed. Tara Neleman received institutional grant support from Acist Medical Systems. Mariusz Tomaniak acknowledges funding as the laureate of the European Society of Cardiology Research and Training Program in the form of the ESC 2018 Grant (T-2018-19,628). Roberto Diletti reports institutional research grant to the Erasmus University Medical Center, consultant to ACIST Medical Systems. The remaining authors have nothing to disclose. Publisher Copyright: © 2022 The Authors

PY - 2022/7/15

Y1 - 2022/7/15

N2 - Background: Vessel Fractional Flow Reserve (vFFR) as assessed by three-dimensional quantitative coronary angiography has high correlation with pressure wire-based fractional flow reserve in both a pre- and post-PCI setting. The present study aims to assess the prognostic value of post-PCI vFFR on the incidence of target vessel failure (TVF), a composite endpoint of cardiac death, target vessel myocardial infarction and target vessel revascularization (TVR) at 5-year follow up. Methods: Post-PCI vFFR was calculated after routine PCI in a total of 748 patients (832 vessels) with available orthogonal angiographic projections of the stented segment. Results: Median age was 65 (IQR 55–74) years, 18.2% were diabetic, and 29.1% presented with stable angina. Median post-PCI vFFR was 0.91 (IQR 0.86–0.95). Vessels were categorized into tertiles based on post-PCI vFFR: low (vFFR <0.88), middle (vFFR 0.88–0.93), and upper (vFFR ≥0.94). Vessels in the lower and middle tertile were more often LADs and had smaller stent diameters (p<0.001). Vessels in the lower and middle tertile had a higher risk of TVF as compared to vessels in the upper tertile (24.6% and 21.5% vs. 17.1%; adjusted HR 1.84 (95%CI 1.15–2.95), p = 0.011, and 1.58 (95%CI 1.02–2.45), p = 0.040) at 5-years follow-up. Additionally, vessels in the lower tertile had higher rates of TVR as compared to vessels in the higher tertile (12.6% vs. 6.5%, adjusted HR 1.93 (95%CI 1.06–3.53), p = 0.033). Conclusion: Lower post-PCI vFFR values are associated with a significantly increased risk of TVF and TVR at 5-years follow-up.

AB - Background: Vessel Fractional Flow Reserve (vFFR) as assessed by three-dimensional quantitative coronary angiography has high correlation with pressure wire-based fractional flow reserve in both a pre- and post-PCI setting. The present study aims to assess the prognostic value of post-PCI vFFR on the incidence of target vessel failure (TVF), a composite endpoint of cardiac death, target vessel myocardial infarction and target vessel revascularization (TVR) at 5-year follow up. Methods: Post-PCI vFFR was calculated after routine PCI in a total of 748 patients (832 vessels) with available orthogonal angiographic projections of the stented segment. Results: Median age was 65 (IQR 55–74) years, 18.2% were diabetic, and 29.1% presented with stable angina. Median post-PCI vFFR was 0.91 (IQR 0.86–0.95). Vessels were categorized into tertiles based on post-PCI vFFR: low (vFFR <0.88), middle (vFFR 0.88–0.93), and upper (vFFR ≥0.94). Vessels in the lower and middle tertile were more often LADs and had smaller stent diameters (p<0.001). Vessels in the lower and middle tertile had a higher risk of TVF as compared to vessels in the upper tertile (24.6% and 21.5% vs. 17.1%; adjusted HR 1.84 (95%CI 1.15–2.95), p = 0.011, and 1.58 (95%CI 1.02–2.45), p = 0.040) at 5-years follow-up. Additionally, vessels in the lower tertile had higher rates of TVR as compared to vessels in the higher tertile (12.6% vs. 6.5%, adjusted HR 1.93 (95%CI 1.06–3.53), p = 0.033). Conclusion: Lower post-PCI vFFR values are associated with a significantly increased risk of TVF and TVR at 5-years follow-up.

UR - http://www.scopus.com/inward/record.url?scp=85129820898&partnerID=8YFLogxK

U2 - 10.1016/j.ijcard.2022.04.021

DO - 10.1016/j.ijcard.2022.04.021

M3 - Article

C2 - 35421516

AN - SCOPUS:85129820898

VL - 359

SP - 14

EP - 19

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -

The prognostic value of angiography-based vessel fractional flow reserve after percutaneous coronary intervention: The FAST Outcome study

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