Baseline Fractional Flow Reserve and Stent Diameter Predict Optimal Post-Stent Fractional Flow Reserve and Major Adverse Cardiac Events After Bare-Metal Stent Deployment JACC-CARDIOVASCULAR INTERVENTIONS Samady, H., McDaniel, M., Veledar, E., De Bruyne, B., Pijls, N. H., Fearon, W. F., Vaccarino, V. 2009; 2 (4): 357-363


We sought to identify baseline clinical, angiographic, and hemodynamic variables associated with optimal bare-metal stent (BMS) deployment, allowing selection of patients for treatment with BMS.Patients with fractional flow reserve (FFR) >0.90 after BMS have low (<6%) major adverse cardiac event rates (MACE). We hypothesized that baseline variables can predict post-stent FFR >0.90 and MACE after BMS.In 586 patients from the multicenter post-BMS FFR registry, we developed multivariable logistic regression models to identify clinical, angiographic, and hemodynamic variables associated with post-stent FFR >or=0.90 and 6-month MACE.After adjusting for potential confounders, baseline FFR (odds ratio [OR]: 5.0) and stent diameter (OR: 2.5 per millimeter) were predictive of post-stent FFR >0.90. Lower FFR (OR: 7.8); smaller stent diameter (OR: 3.7 per millimeter); longer stent length (OR: 1.0 per millimeter); and larger minimal luminal diameter (OR: 2.2 per millimeter) were predictors of MACE. In patients receiving 3-mm diameter stents, baseline FFR >0.70 yielded significantly higher likelihood of achieving post-stent FFR >0.90 than baseline FFR 0.70 (40% vs. 15% vs. 13%, p < 0.05).In patients receiving BMS, baseline FFR and stent diameter are predictors of post-stent FFR >0.90; and baseline FFR, stent diameter, stent length, and minimal luminal diameter are predictors of MACE. These variables may allow selection of patients who will have excellent results with BMS.

View details for DOI 10.1016/j.jcin.2009.01.008

View details for Web of Science ID 000278970900015

View details for PubMedID 19463450