Clinical research

DOI: 10.4244/EIJ-D-23-00517

Changes in post-PCI physiology based on anatomical vessel location: a DEFINE PCI substudy

Mitsuaki Matsumura1, BS; Akiko Maehara1,2, MD; Justin E. Davis3, MD; Gautam Kumar4, MD; Andrew Sharp5, MD; Habib Samady4, MD; Arnold H. Seto6, MD; David Cohen1,7, MD; Manesh R. Patel8, MD; Ziad A. Ali1,7, MD, DPhil; Gregg W. Stone9, MD; Allen Jeremias1,7, MD, MSc


Background: Anatomical vessel location affects post-percutaneous coronary intervention (PCI) physiology.

Aims: We aimed to compare the post-PCI instantaneous wave-free ratio (iFR) in left anterior descending (LAD) versus non-LAD vessels and to identify the factors associated with a suboptimal post-PCI iFR.

Methods: DEFINE PCI was a multicentre, prospective, observational study in which a blinded post-PCI iFR pullback was used to assess residual ischaemia following angiographically successful PCI.

Results: Pre- and post-PCI iFR recordings of 311 LAD and 195 non-LAD vessels were compared. Though pre-PCI iFR in the LAD vessels (median 0.82 [0.63, 0.86]) were higher compared with those in non-LAD vessels (median 0.72 [0.49, 0.84]; p<0.0001), post-PCI iFR were lower in the LAD vessels (median 0.92 [0.88, 0.94] vs 0.98 [0.95, 1.00]; p<0.0001). The prevalence of a suboptimal post-PCI iFR of <0.95 was higher in the LAD vessels (77.8% vs 22.6%; p<0.0001). While the overall frequency of residual physiological diffuse disease (31.4% vs 38.6%; p=0.26) and residual focal disease in the non-stented segment (49.6% vs 50.0%; p=0.99) were similar in both groups, residual focal disease within the stented segment...

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Volume 19 Number 11
Dec 18, 2023
Volume 19 Number 11
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