Fractional flowreserve (FFR) after percutaneous coronary intervention (PCI) reflects thedegree of maximal flow reduction by residual disease after PCI. The clinicalrelevance of post-PCI FFR is well known, but its long-term prognostic impact isstill unclear.

A total of 2,128patients who underwent drug-eluting stent implantation and post-PCI FFRmeasurement with 5-year outcome data were analyzed. The primary outcome wastarget vessel failure (TVF) at 5 years, a composite of cardiac death, targetvessel myocardial infarction (TVMI), and target vessel revascularization (TVR).The secondary outcome was a composite of cardiac death or TVMI and individualoutcomes at 5 years. 

During 5 years of follow-up,the cumulative incidence of TVF was 12.0%, and that of cardiac death of TVMIwas 3.5%. The Median (IQR) post-PCI FFR of the target vessel was 0.88(0.84-0.93). The risk of TVF increased along with the decrease of post-PCI FFR(adjusted hazard ratio [HR] per 0.01 FFR decrease 1.044, 95% confidenceinterval [CI] 1.025-1.063, p-value<0.001). This significant inverseassociation was also observed regarding a composite of cardiac death or TVMI(adjusted HR per 0.01 FFR decrease 1.042, 95% CI 1.006-1.080,p-value=0.023).The risk of TVR was also significantly associated with post-PCIFFR values inrevascularization in stented segments (adjusted HR per 0.01 FFR decrease 1.036,95% CI 1.010-1.063, p-value=0.007) and non-stented segments (adjusted HR per0.01 FFR decrease 1.054, 95% CI 1.023-1.087, p-value<0.001). 

The long-term outcome results of the Internation Post-PCI FFR Extendedregistry showed that the prognostic impact of post-PCI FFR is maintained until5 years of follow-up, and post-PCI FFR is associated with target vessel-relatedevents, including cardiac death or TVMI.