Clinical value of post–percutaneous coronary intervention fractional flow reserve value: A systematic review and meta-analysis Goran Rimac, MD, William.

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Clinical value of post–percutaneous coronary intervention fractional flow reserve value: A systematic review and meta-analysis Goran Rimac, MD, William F. Fearon, MD, Bernard De Bruyne, MD, PhD, Fumiaki Ikeno, MD, Hitoshi Matsuo, MD, Zsolt Piroth, MD, Olivier Costerousse, PhD, Olivier F. Bertrand, MD, PhD American Heart Journal Volume 183, Pages 1-9 (January 2017) DOI: 10.1016/j.ahj.2016.10.005 Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 1 Studies selection flowchart. American Heart Journal 2017 183, 1-9DOI: (10.1016/j.ahj.2016.10.005) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 2 Distribution of post-PCI FFR values. Distribution of post-PCI mean FFR values in chronological order. Red dots represent studies with balloon angioplasty only. The shaded zone delineated by blue and red lines represents FFR between 0.75 and 0.80. American Heart Journal 2017 183, 1-9DOI: (10.1016/j.ahj.2016.10.005) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 3 Cumulative incidence of post-PCI FFR values. Cumulative post-PCI mean FFR values incidence showed by the blue line and dots. Note that 80% of studies presented post-PCI mean FFR values between 0.85 and 0.95 (shaded zone) and that, in 50% of studies, 0.90 was obtained (red lines). American Heart Journal 2017 183, 1-9DOI: (10.1016/j.ahj.2016.10.005) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 4 Correlations between baseline and procedural data and post-PCI FFR. Correlations between prior MI, post-PCI stenosis, post-PCI lumen diameter, pre-PCI FFR, and post-PCI FFR values. American Heart Journal 2017 183, 1-9DOI: (10.1016/j.ahj.2016.10.005) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 5 A and B, Meta-regression analysis of stent or DES rate and post-PCI FFR values. A, Data show a significant relationship between % of stent implantation (vs balloon angioplasty alone) and post-PCI FFR values. B, No significant difference was observed in post-PCI FFR values with DES compared with BMS. American Heart Journal 2017 183, 1-9DOI: (10.1016/j.ahj.2016.10.005) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 6 A and B, Meta-regression analysis of post-PCI FFR values and repeat PCI (A) or MACE (B). A, Data show that the higher the post-PCI FFR value, the lower the risk of repeat PCI. Post-PCI FFR ≥0.90 is associated with <10% risk of repeat PCI. B, Data show that the higher the post-PCI FFR value, the lower the risk of MACE. American Heart Journal 2017 183, 1-9DOI: (10.1016/j.ahj.2016.10.005) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 7 Difference in post-PCI FFR values if focal or diffuse disease. Illustration of the effect of stent deployment in focal lesion (A) and diffuse (B) disease and the immediate post-PCI FFR values. American Heart Journal 2017 183, 1-9DOI: (10.1016/j.ahj.2016.10.005) Copyright © 2016 Elsevier Inc. Terms and Conditions