Decrease of Fractional Flow Reserve Shortly After Percutaneous Coronary Intervention

Background The aim of the present study was to quantitatively assess the physiological acute recoil after percutaneous coronary intervention (PCI), and to determine the relation between it and target lesion revascularization (TLR) in the chronic phase. Methods and Results This study evaluated 76 patients who underwent elective PCI between May 1997 and December 2001: plain old balloon angioplasty (POBA) in 50 patients and bare metal stent implantation in 26 patients. Fractional flow reserve (FFR) was measured immediately (FFR0m) and 15 min (FFR15m) after the final dilation, and the difference (dif-FFR) was calculated. In POBA patients with TLR, FFR15m was significantly low (0.79±0.05 vs 0.87 ±0.08, p<0.001) and dif-FFR was significantly high (0.06±0.04 vs -0.01±0.04, p<0.001) compared with the patients without TLR. The patients with a larger dif-FFR value (≥0.05) had a higher rate of TLR (92%). Dif-FFR was the strongest independent predictor of TLR. Conclusions The changes in FFR during the time course shortly after coronary intervention can be detected and a decrease in the first 15 min after PCI is associated with a higher rate of TLR. (Circ J 2006; 70: 1327 - 1331)