RESUMO
AIM: To evaluate the distribution of a generic diastolic pressure ratio (dPR) after angiographically successful percutaneous coronary intervention (PCI) and to assess its association with the 2year incidence of target vessel failure (TVF), defined as a composite of cardiac mortality, target vessel revascularisation, target vessel myocardial infarction and stent thrombosis. METHODS: The dPR SEARCH study is a post hoc analysis of the prospective single-centre FFR-SEARCH registry, in which physiological assessment was performed after angiographically successful PCI in a total of 1000 patients, using a dedicated microcatheter. dPR was calculated offline with recently validated software in a subset of 735 patients. RESULTS: Mean post-PCI dPR was 0.95⯱ 0.06. Post-PCI dPR was ≤â¯0.89 in 15.2% of the patients. The cumulative incidence of TVF at 2year follow-up was 9.4% in patients with a final post-PCI dPR ≤â¯0.89 as compared to 6.1% in patients with a post-PCI dPR >â¯0.89 (adjusted hazard ratio [HR] for dPR ≤â¯0.89: 1.53; 95% CI 0.74-3.13; pâ¯= 0.249). dPR ≤â¯0.89 was associated with significantly higher cardiac mortality at 2 years; adjusted HR 2.40; 95% CI 1.01-5.68; pâ¯= 0.047. CONCLUSIONS: In a real-world setting, despite optimal angiographic PCI results, 15.2% of the patients had a final post-PCI dPR of ≤â¯0.89, which was associated with a higher incidence of TVF and a significantly higher cardiac mortality rate.