%0 Journal Article
%T Angiographic Findings and Post-Percutaneous Coronary Intervention Fractional Flow Reserve.
%A Zhang J
%A Hwang D
%A Yang S
%A Hu X
%A Lee JM
%A Nam CW
%A Shin ES
%A Doh JH
%A Hoshino M
%A Hamaya R
%A Kanaji Y
%A Murai T
%A Zhang JJ
%A Ye F
%A Li X
%A Ge Z
%A Chen SL
%A Kakuta T
%A Wang J
%A Koo BK
%J JAMA Netw Open
%V 7
%N 6
%D 2024 Jun 3
%M 38904958
%F 13.353
%R 10.1001/jamanetworkopen.2024.18072
%X <B>UNASSIGNED: </B>The associations between angiographic findings and post-percutaneous coronary intervention (PCI) fractional flow reserve (FFR) and their clinical relevance according to residual functional disease burden have not been thoroughly investigated.<BR><B>UNASSIGNED: </B>To evaluate the association of angiographic and physiologic parameters according to residual functional disease burden after drug-eluting stent implantation.<BR><B>UNASSIGNED: </B>This cohort study population was from the International Post-PCI FFR registry, which incorporated 4 registries from Korea, China, and Japan. Patients who underwent angiographically successful second-generation drug-eluting stent implantation and post-PCI FFR measurement were included in the analysis. The patients were divided into 3 groups according to the residual disease burden (post-PCI FFR ≤0.80 [residual ischemia], 0.81-0.86 [suboptimal], and >0.86 [optimal]). The data were collected from August 23, 2018, to June 11, 2019, and the current analysis was performed from January 11, 2022, to October 7, 2023.<BR><B>UNASSIGNED: </B>Angiographic parameters and post-PCI FFR.<BR><B>UNASSIGNED: </B>The primary outcome was target vessel failure (TVF), defined as a composite of cardiac death, target vessel-related myocardial infarction, and target vessel revascularization (TVR) at 2 years.<BR><B>UNASSIGNED: </B>In this cohort of 2147 patients, the mean (SD) age was 64.3 (10.0) years, and 1644 patients (76.6%) were men. Based on the post-PCI physiologic status, 269 patients (12.5%) had residual ischemia, 551 (25.7%) had suboptimal results, and 1327 (61.8%) had optimal results. Angiographic parameters had poor correlations with post-PCI FFR (r < 0.20). Post-PCI FFR was isolated from all angiographic parameters in the unsupervised hierarchical cluster analysis. Post-PCI FFR was associated with the occurrence of TVF (adjusted hazard ratio [AHR] per post-PCI FFR 0.01 increase, 0.94 [95% CI, 0.92-0.97]; P < .001), but angiographic parameters were not. The residual ischemia group had a significantly higher rate of TVF than the suboptimal group (AHR, 1.75 [95% CI, 1.08-2.83]; P = .02) and the optimal group (AHR, 2.94 [95% CI, 1.82-4.73]; P < .001). The TVR in the residual ischemia group was predominantly associated with TVR in the nonstented segment (14 [53.8%]), unlike the other 2 groups (3 [10.0%] in the suboptimal group and 13 [30.2%] in the optimal group).<BR><B>UNASSIGNED: </B>In this cohort study of the International Post-PCI FFR registry, a low degree of associations were observed between angiographic and physiologic parameters after PCI. Post-PCI FFR, unlike angiographic parameters, was associated with clinical events and the distribution of clinical events. The current study supports the use of post-PCI FFR as a procedural quality metric and further prospective study is warranted.