Lots of interesting abstracts and cases were submitted for TCTAP 2024. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!
TCTAP A-060
Contrasting Prognostic Value of Discordance Between Fractional Flow Reserve and Resting Distal-to-aortic Coronary Pressure Ratio in Coronary Lesion
By Somin Lim, Jung-Min Ahn, Ha Hye Jo, Joongmin Lee, Jinho Lee, Yeonwoo Choi, Hoyun Kim, Sang Yong Jo, Do-Yoon Kang, Duk-Woo Park, Seung-Jung Park
Presenter
Somin Lim
Authors
Somin Lim1, Jung-Min Ahn1, Ha Hye Jo1, Joongmin Lee1, Jinho Lee2, Yeonwoo Choi3, Hoyun Kim4, Sang Yong Jo5, Do-Yoon Kang1, Duk-Woo Park1, Seung-Jung Park1
Affiliation
Asan Medical Center, Korea (Republic of)1, Kyung Hee University Hospital, Korea (Republic of)2, Chnagwon Hanmaeum, Korea (Republic of)3, Sejong Hospital, Korea (Republic of)4, Dong-A University Hosital, Korea (Republic of)5
View Study Report
TCTAP A-060
FFR
Contrasting Prognostic Value of Discordance Between Fractional Flow Reserve and Resting Distal-to-aortic Coronary Pressure Ratio in Coronary Lesion
Somin Lim1, Jung-Min Ahn1, Ha Hye Jo1, Joongmin Lee1, Jinho Lee2, Yeonwoo Choi3, Hoyun Kim4, Sang Yong Jo5, Do-Yoon Kang1, Duk-Woo Park1, Seung-Jung Park1
Asan Medical Center, Korea (Republic of)1, Kyung Hee University Hospital, Korea (Republic of)2, Chnagwon Hanmaeum, Korea (Republic of)3, Sejong Hospital, Korea (Republic of)4, Dong-A University Hosital, Korea (Republic of)5
Background
Fractional flow reserve (FFR) and restingdistal-to-aortic coronary pressure ratio (Pd/Pa) play pivotal roles in guidingtreatment decision for coronary revascularization in cases of intermittentstenosis. Discordance between FFR and resting Pd/Pa, observed in up to 20% ofcases, has prompted interest in understanding its clinical implications.However only small cohort studies have demonstrated that there were nosignificant differences in clinical outcomes between discordant lesions. This study sought to investigate theclinical outcomes of discordant lesions using a large, multicenter cohort.
Methods
From the IRIS-FFR(Interventional Cardiology Research In-cooperation Society Fractional FlowReserve) registry, a total of 9737 lesions from 7376 patients were stratifiedbased on resting Pd/Pa and FFR values. The primary outcome was 5-year target-vesselfailure (TVF), including target lesion myocardial infarction (TLMI) and targetvessel revascularization (TVR), considering all-cause death as a competingfactor. Secondary outcomes comprised each composite of the primary outcome. Allclinical outcomes were adjusted for patient and lesion differences.
Results
A total of 15.91% oflesions exhibited discordance between resting Pd/Pa and FFR. The group withresting Pd/Pa ≤ 0.93 and FFR > 0.80 showed a higher risk of TVF comparedwith the group with resting Pd/Pa > 0.93 and FFR ≤ 0.80 (adjusted Hazard Ratio(aHR) 1.74 [95% CI 1.14-2.66], P-value=0.010). Secondary outcomes showed nosignificant difference between discordant groups (TLMI: aHR 2.07 [95% CI0.36-11.88], P-value=0.416; TVR: aHR 1.37 [95% CI 0.86-2.20], P-value=0.187). Patientsin resting Pd/Pa > 0.93, FFR ≤ 0.80 group demonstrated the lowest 5-yearsurvival rate at 91.0% compared with other groups in Kaplan-Meier curve(P-value<0.001). Comparing the Pd/Pa≤0.93, FFR>0.80 group and the Pd/Pa>0.93,FFR≤0.80 group, the adjusted HR was 0.34 (95% CI. 0.17-0.66, P-value=0.001).
Conclusion
In clinical outcomebetween discordant lesions, FFR demonstrates a stronger association with TVF,while mortality shows a more pronounced relationship with resting Pd/Pa. Whendeciding on clinical treatment strategies, it is important to consider bothpatient factors and lesion characteristics.