Trends in LDL-C following coronary angiography involving assessment by fractional flow reserve in obstructive vs non-obstructive coronary artery disease

被引：1

作者：

Wilkinson, Michael J. ^{[1
]}

Xu, Irvin ^{[1
]}

Vasudevan, Rajiv S. ^{[1
]}

You, Hyeri ^{[2
]}

Xu, Ronghui ^{[3
]}

Taub, Pam R. ^{[1
]}

机构：

[1] Univ Calif San Diego, Dept Med, Div Cardiovasc Med, 9500 Gilman Dr, La Jolla, CA 92093 USA

[2] Univ Calif San Diego, Altman Clin & Translat Res Inst, Biostat Unit, 9500 Gilman Dr, La Jolla, CA 92093 USA

[3] Univ Calif San Diego, Herbert Wertheim Sch Publ Hlth, Dept Math, 9500 Gilman Dr, La Jolla, CA 92093 USA

来源：

AMERICAN JOURNAL OF PREVENTIVE CARDIOLOGY | 2023年 / 13卷

基金：

美国国家卫生研究院;

关键词：

Coronary artery disease; Coronary angiography; Fractional flow reserve; Dyslipidemia; STATIN THERAPY;

D O I：

10.1016/j.ajpc.2023.100473

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: We sought to determine whether management of LDL-C following invasive angiography and assessment by fractional flow reserve (FFR) differs between those with obstructive vs non-obstructive CAD.Methods: Retrospective study of 721 patients undergoing coronary angiography involving assessment by FFR between 2013 and 2020 at a single academic center. Groups with obstructive vs non-obstructive CAD by index angiographic and FFR findings were compared over 1 year of follow-up.Results: Based on index angiographic and FFR findings, 421 (58%) patients had obstructive CAD vs 300 (42%) with non-obstructive CAD, mean (+/- SD) age 66 +/- 11 years, 217 (30%) women, and 594 (82%) white. There was no difference in baseline LDL-C. At 3-months follow-up, LDL-C was lower than baseline in both groups, with no between group difference. In contrast, at 6-months, median (Q1, Q3) LDL-C was significantly higher in non -obstructive vs obstructive CAD (LDL-C 73 (60, 93) vs 63 (48, 77) mg/dL, respectively (p = 0.003), (p = 0.001 in multivariable linear regression)). At 12-months, LDL-C remained higher in non-obstructive vs obstructive CAD (LDL-C 73 (49, 86) vs 64 (48, 79) mg/dL, respectively, although not statistically significant (p = 0.104)). The rate of high-intensity statin use was lower among those with non-obstructive CAD vs obstructive CAD at all time points (p < 0.05).Conclusions: After coronary angiography involving FFR, there is intensification of LDL-C lowering at 3-months follow-up in both obstructive and non-obstructive CAD. However, by 6-months follow-up LDL-C is signifi-cantly higher among those with non-obstructive CAD vs obstructive CAD. Following coronary angiography involving FFR, patients with non-obstructive CAD may benefit from greater attention to LDL-C lowering to reduce residual ASCVD risk.

引用

页数：7