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-003
Association of Pre-Procedure, Post-Procedure Quantitative Flow Ratio, and Prognosis in Patients Underwent Percutaneous Coronary Intervention: A Mediation Analysis
By Sheng Yuan, Rui Zhang, Zhangyu Lin, Kefei Dou
Presenter
Sheng Yuan
Authors
Sheng Yuan1, Rui Zhang1, Zhangyu Lin1, Kefei Dou1
Affiliation
Fuwai Hospital, China1
View Study Report
TCTAP A-003
FFR
Association of Pre-Procedure, Post-Procedure Quantitative Flow Ratio, and Prognosis in Patients Underwent Percutaneous Coronary Intervention: A Mediation Analysis
Sheng Yuan1, Rui Zhang1, Zhangyu Lin1, Kefei Dou1
Fuwai Hospital, China1
Background
It has been established that the prognosis of patients following percutaneous coronary intervention (PCI) is correlated with both pre- and post-PCI QFR. However, it is currently unclear how much post-PCI QFR mediates the relationship between pre-PCI QFR and prognosis.
Methods
Retrospective QFR evaluation was carried out in treated vessels from the all-comers PANDA III trial. The primary outcome measure was the vessel-oriented composite endpoint (VOCE), which is a combination of the following: myocardial infarction linked to the vessel, ischemia-driven revascularization related to the vessel, or cardiac death at two years. Using survival analysis, the relationship between pre-PCI QFR and post-PCI QFR with VOCE was examined separately. Examining the direct and indirect effects of pre-PCI QFR on VOCE, mediation analysis was performed with post-PCI QFR acting as a mediator and clinical risk variables acting as confounders.
Results
A total of 2146 vessels (1744 patients) with analyzable paired pre-PCI QFR and post-PCI QFR was included in analysis. Lower pre-PCI QFR value (HR: 2.11, 95% CI: 1.33, 3.36; p =0.002) or post-PCI QFR value (HR: 4.32, 95% CI: 3.07, 6.07; p <0.001) was associated with higher risk of VOCE. Mediation analysis with post-PCI QFR as a mediator revealed that pre-PCI QFR exerted a significant direct effect (69.61%) on the risk of VOCE. Post-PCI QFR, and post-PCI QFR explained only 30.39% of the association between pre-PCI QFR and VOCE.
Conclusion
In this study, post-PCI FFR mediated only a small amount of the link between pre-PCI QFR and VOCE. Patients with low pre-PCI QFR may not benefit a lot from effective PCI. Consequently, in addition to post-PCI QFR, pre-PCI QFR may offer additional prognostic information.