{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T03:15:38Z","timestamp":1793330138047,"version":"4.5.0"},"reference-count":73,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Fractional flow reserve (FFR) after percutaneous coronary intervention (PCI) is generally considered to reflect residual disease. Yet the clinical relevance of post-PCI FFR after drug-eluting stent (DES) implantation remains unclear.<\/jats:p><\/jats:sec>Objective<\/jats:title>To evaluate the clinical relevance of post-PCI FFR measurement after DES implantation.<\/jats:p><\/jats:sec>Data Sources<\/jats:title>MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched for relevant published articles from inception to June 18, 2022.<\/jats:p><\/jats:sec>Study Selection<\/jats:title>Published articles that reported post-PCI FFR after DES implantation and its association with clinical outcomes were included.<\/jats:p><\/jats:sec>Data Extraction and Synthesis<\/jats:title>Patient-level data were collected from the corresponding authors of 17 cohorts using a standardized spreadsheet. Meta-estimates for primary and secondary outcomes were analyzed per patient and using mixed-effects Cox proportional hazard regression with registry identifiers included as a random effect. All processes followed the Preferred Reporting Items for Systematic Review and Meta-analysis of Individual Participant Data.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary outcome was target vessel failure (TVF) at 2 years, a composite of cardiac death, target vessel myocardial infarction (TVMI), and target vessel revascularization (TVR). The secondary outcome was a composite of cardiac death or TVMI at 2 years.<\/jats:p><\/jats:sec>Results<\/jats:title>Of 2268 articles identified, 29 studies met selection criteria. Of these, 28 articles from 17 cohorts provided data, including a total of 5277 patients with 5869 vessels who underwent FFR measurement after DES implantation. Mean (SD) age was 64.4 (10.1) years and 4141 patients (78.5%) were men. Median (IQR) post-PCI FFR was 0.89 (0.84-0.94) and 690 vessels (11.8%) had a post-PCI FFR of 0.80 or below. The cumulative incidence of TVF was 340 patients (7.2%), with cardiac death or TVMI occurring in 111 patients (2.4%) at 2 years. Lower post-PCI FFR significantly increased the risk of TVF (adjusted hazard ratio [HR] per 0.01 FFR decrease, 1.04; 95% CI, 1.02-1.05; P<\/jats:italic>\u2009&lt;\u2009.001). The risk of cardiac death or MI also increased inversely with post-PCI FFR (adjusted HR, 1.03; 95% CI, 1.00-1.07, P<\/jats:italic>\u2009=\u2009.049). These associations were consistent regardless of age, sex, the presence of hypertension or diabetes, and clinical diagnosis.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>Reduced FFR after DES implantation was common and associated with the risks of TVF and of cardiac death or TVMI. These results indicate the prognostic value of post-PCI physiologic assessment after DES implantation.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2022.32842","type":"journal-article","created":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T16:29:24Z","timestamp":1663864164000},"page":"e2232842","source":"Crossref","is-referenced-by-count":101,"title":["Prognostic Implications of Fractional Flow Reserve After Coronary Stenting"],"prefix":"10.1001","volume":"5","author":[{"given":"Doyeon","family":"Hwang","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bon-Kwon","family":"Koo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinlong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiesuck","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seokhun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minsang","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun Pil","family":"Yun","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joo Myung","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang-Wook","family":"Nam","sequence":"additional","affiliation":[{"name":"Department of Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun-Seok","family":"Shin","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Ulsan Hospital, Ulsan, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joon-Hyung","family":"Doh","sequence":"additional","affiliation":[{"name":"Department of Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shao-Liang","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsunekazu","family":"Kakuta","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabor G.","family":"Toth","sequence":"additional","affiliation":[{"name":"University Heart Centre Graz, Medical University Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zsolt","family":"Piroth","sequence":"additional","affiliation":[{"name":"Gottsegen Hungarian Institute of Cardiology, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils P.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Weatherhead PET Center For Preventing and Reversing Atherosclerosis, Division of Cardiology, Department of Medicine, University of Texas Medical School and Memorial Hermann Hospital, Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nico H. 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