AIMS
We sought to investigate the influence of target vessel on prognostic relevance of fractional flow reserve (FFR) after percutaneous coronary intervention (PCI).
METHODS AND RESULTS
A total of 835 patients with available FFR after 2nd generation drug-eluting stent (DES) implantation were included in this study. The primary outcome was target-vessel failure (TVF), including cardiac death, target-vessel related myocardial infarction, and clinically-driven target-vessel revascularization. The target vessel was the left anterior descending artery (LAD) in 603 patients (72.2%) and non-LAD in 232 patients (27.8%). The distribution pattern of post-PCI FFR values was different between the LAD and non-LAD (p < 0.001), and optimal cut-off values of post-PCI FFR for predicting TVF were 0.82 and 0.88 in the LAD and non-LAD, respectively. The cumulative incidence of TVF was significantly higher in patients with lower post-PCI FFR than each cut-off value (10.9% vs. 2.5%, hazard ratio [HR] 4.08, 95% confidence interval [CI] 2.63-6.34, p < 0.001 in LAD; 8.0% vs. 1.9%, HR 6.00, 95% CI 1.78-20.26, p = 0.004 in non-LAD).
CONCLUSIONS
Higher post-PCI FFR after 2nd generation DES implantation was associated with better clinical outcomes. Different cut-off values of post-PCI FFR need to be applied according to target vessels.