Abstract 4144277: Analysis risk factors of long-term adverse outcomes and construction of nomogram based on fractional flow reserve for coronary artery disease patients with an intermediate stenosis

Background: The role of fractional flow reserve (FFR) in intermediate lesions has been widely demonstrated and recommended by guidelines. However, the long-term outcomes in patient with an intermediate stenosis received FFR have not yet been investigated comprehensively. Methods: We retrospective included 558 patients underwent both coronary artery angiography (CAG) and FFR. All patients were randomly divided into a training set containing 390 individuals and a validation set of 168 individuals at a ratio of 7:3. Valuable predictors were screened for constructing nomogram by statistical and clinical significance. The prediction efficiency of nomogram was evaluated by multiple methods, including C-index, area under the curve (AUC), calibration curves and decision-curve analysis (DCA). Results: During a median follow-up of 6.2 years, 87 (15.59%) adverse events were documented. The nomogram consists of age, smoking, hypertension, diabetes mellitus (DM), hyperuricemia, and FFR≤0.8 six factors. The C-index in the training and validation sets were 0.807 and 0.832. The AUC of 3-year, 5-year, 7-year receiver operating characteristic (ROC) curves of training set were 0.697, 0.823, 0.854, and of validation set were 0.845, 0.824, 0.856. The calibration curves and DCAs illustrated the ability of the nomogram to predict long-term adverse outcomes and its net benefits in clinical practice. Conclusions: Age, DM, and hyperuricemia were independently associated with longterm adverse outcomes, and the constructed nomogram based on FFR may be used as a visible tool to predict long-term adverse outcomes for coronary artery disease (CAD) patients with an intermediate stenosis.