Coronary Disease Clinical Trial
Official title:
International Post PCI FFR Registry for Prognostic Factors After Coronary Stenting
The prognostic factors after a percutaneous coronary intervention (PCI) have not been comprehensively investigated. The investigators sought to develop a risk model to predict future clinical events after PCI using contemporary coronary stents.
Percutaneous coronary intervention (PCI) is a standard treatment strategy for coronary artery
disease (CAD). With the presence of myocardial ischemia, PCI reduces the risks of death,
myocardial infarction (MI) and revascularization compared to medical therapy. However, the
risk of future clinical events still remain high and about 10% of patients experienced
further cardiovascular events after PCI. There are several factors that are associated with
these poor outcomes. Known patient-related risk factors are diabetes mellitus, chronic kidney
disease, left ventricular dysfunction, previous MI and presentation with the acute coronary
syndrome. Procedure-related factors, such as stent underexpension, malapposition, edge
dissection, the number of the used stent and total stent length, are also related to poor
prognosis after PCI. Recent studies reported that fractional flow reserve (FFR) after
coronary stenting, or post PCI FFR, was associated with future clinical outcomes after PCI
and low post PCI FFR value was associated with procedural factors. However, all of these risk
factors were identified in individual studies there have been no studies that comprehensively
evaluated these risk factors. Therefore, the investigators sought to investigate the risk
predictors of future clinical events in patients after PCI and develop a risk model,
incorporating clinical, angiographic, and physiologic factors, to predict the clinical events
after PCI using contemporary coronary stents.
The study population of this study is from the International Post PCI FFR Registry, which
included 4 different registries from Korea, China, and Japan. All patients in this registry
are available with clinical, angiographic and physiologic data and used 2nd generation
drug-eluting stent (DES) for PCI. The COE-PERSPECTIVE registry (NCT01873560) was designed to
evaluate the clinical relevance of post PCI FFR from 9 hospitals in Korea and Japan and
enrolled a total of 835 patients available post PCI FFR value after angiographically
successful PCI between May 2013 and December 2016. The 3V-FFR-FRIENDS registry (NCT01621438)
enrolled a total of 1,136 patients (3,298 vessels) who underwent 3-vessel FFR measurements
from 12 centers in Korea, Japan, and China between November 2011 and March 2014. Among them,
266 patients with 337 vessels who measure post PCI FFR values were included in this
international registry. The DKCRUSH VII registry (ChiCTR-PRCH-12001976) enrolled a total of
1,476 patients from 9 hospitals (5 hospitals in China, 2 hospitals in the United States, 1
hospital in Asia and 1 hospital in European country) between May 2012 and September 2013 to
evaluate the prognostic value of post PCI FFR on patients' future outcome. For this
international registry, 780 patients with 794 vessels from Nanjing First Hospital in China,
who were available with whole clinical, angiographic and physiologic data, were included in
this registry. Last, the Institutional registry of Tsuchiura Kyodo General Hospital, Ibaraki,
Japan included 347 patients (357 vessels) who underwent PCI and final post-PCI FFR
measurement.
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