FFR-SEARCH Study Investigates Relationship of Post-PCI FFR and 30-Day Outcomes

 

May 1, 2019–Findings on routine fractional flow reserve (FFR) measurement after percutaneous coronary intervention (PCI) in the FFR-SEARCH study were published by Rutger J. van Bommel, MD, et al in Circulation: Cardiovascular Interventions.

FFR-SEARCH is a prospective registry in which FFR measurements were performed after PCI in 1,000 consecutive patients. The investigators sought to evaluate post-PCI FFR values, identify predictors for a low post-PCI FFR, and investigate whether there is a relationship between postprocedural FFR and outcome during 30-day follow-up.

In the study, the clinical endpoint was defined as a composite of death, target vessel revascularization, or nonfatal myocardial infarction at 30-day follow-up. All FFR measurements were performed under maximum hyperemia with intravenous adenosine using the Navvus RXi system (Acist Medical Systems, Inc.).

As summarized in Circulation: Cardiovascular Interventions, measurement of post-PCI FFR was successful in 959 patients (96%). A total of 1,165 lesions were assessed. There were no complications related to the microcatheter. A total of 322 patients with ST-segment elevation myocardial infarction with 371 measured lesions were excluded, leaving 637 patients with 794 measured lesions for the final analysis.

The investigators found that overall post-PCI FFR was 0.90 ± 0.07. In 396 lesions (50%), post-PCI FFR was > 0.90. A total of 357 patients (56%) had one or more lesions with a post-PCI FFR ≤ 0.90, and 73 patients (11%) had one or more lesions with a post-PCI FFR ≤ 0.80 with post-PCI FFR ≤ 0.80 in 78 lesions (9.8%).

The investigators noted that complex lesion characteristics, use of multiple stents, and smaller reference vessel diameter were associated with post-PCI FFR ≤ 0.90. During follow-up, 11 patients (1.8%) reached the clinical endpoint. There was no significant relationship between post-PCI FFR and the clinical endpoint at 30-day follow-up (P = .636).

In Circulation: Cardiovascular Interventions, the investigators concluded that routine measurement of post-PCI FFR using a monorail microcatheter is safe and feasible. Additionally, they reported that several lesion and patient characteristics were associated with a low post-PCI FFR and that post-PCI FFR did not correlate with clinical events at 30 days.

 

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Cardiac Interventions Today (ISSN 2572-5955 print and ISSN 2572-5963 online) is a publication dedicated to providing comprehensive coverage of the latest developments in technology, techniques, clinical studies, and regulatory and reimbursement issues in the field of coronary and cardiac interventions. Cardiac Interventions Today premiered in March 2007 and each edition contains a variety of topics in a flexible format, including articles covering various perspectives on current clinical topics, in-depth interviews with expert physicians, overviews of available technologies, industry news, and insights into the issues affecting today's interventional cardiology practices.