Author + information
- Arvydas Baranauskas1,
- Giedrius Davidavicius1,
- Vilhelmas Bajoras2,
- Aleksandras Kibarskis1,
- Valdas Bilkis1 and
- Aleksandras Laucevicius1
There is still a controversy in the treatment of long coronary lesions. Therefore, systemic data on the factors influencing PCI outcomes in the setting of diffuse coronary artery disease is needed. The aim of our study was to evaluate the influence of post procedural FFR on long term outcomes after FFR guided PCI on long coronary lesions.
A total of 74 consecutive patients with significant (FFR<0.8) coronary artery lesions ≥30 mm in length were included to the prospective study. All patients underwent FFR guided PCI with new generation Biolimus, Everolimus or Zotarolimus eluting stents. 100% angiographic procedure success was achieved. Based on post procedural FFR patients were divided into two groups: FFR≥0.9 (n=26) and FFR<0.9 (n=48). The primary outcome was target vessel revascularization (TVR) at one year. Secondary outcomes included late lumen loss (LLL) and major adverse cardiac events (MACE) at one year. In addition, the regression analysis between post procedural FFR and outcomes at follow-up was performed. The angiographic and FFR follow-up was scheduled at 9 months, clinical follow-up at 12 months after the procedure.
The average post procedural FFR in the groups of FFR≥0.9 and FFR<0.9 was 0.94±0.04 and 0.85±0.05 respectively. The baseline clinical characteristics were similar between the two groups including mean age 66.81±8.61 and 65.71±9.95 years (p=0,580), male gender 65.4% and 76.6% (p=0.304), diabetes 19.2% and 23.4% (p=0.680). However, the length of stents needed to cover the lesion was significantly longer (55.17±15.2 vs. 42.15±8.39 mm, p<0,001) and there were more bifurcation lesions [24 (51.1%) vs. 5 (19.2%), p=0,008] in FFR<0.9 group. At follow-up, TVR rate was 4.2% vs. 10.9% (p=0.342), MACE rate 20.8% vs. 21.3% (p=0.965), LLL 0.19±0.43 vs. 0.27±0.41 (p=0.540) in the groups of FFR≥0.9 and FFR<0.9 respectively. On regression analysis there was no statistically significant correlation between post procedural FFR and clinical outcomes at follow-up.
Longer stent length and bifurcation lesions are associated with lower post procedural FFR values, but FFR after PCI on long coronary lesions has no predictive value on long term clinical outcomes.