Long-term prognostic value of quantitative-flow-ratio-concordant revascularization in stable coronary artery disease

被引：3

作者：

Cortes, Carlos ^{[1
,11
]}

Fernandez-Corredoira, Pablo M. ^{[2
]}

Liu, Lili ^{[3
]}

Lopez-Palop, Ramon ^{[4
]}

Rivero, Fernando ^{[5
]}

Jimenez, Octavio ^{[6
]}

Freites, Alfonso

Goncalves-Ramirez, Luis R.

Minguito, Carlos ^{[8
]}

Concepcion, Ricardo ^{[7
]}

Perezi, Ainhoa ^{[9
]}

del Val, David

Leithod, Gunnar ^{[4
]}

Oberhuber-Kurth, Jonas ^{[10
]}

Amat-Santos, Ignacio J.

Diarte, Jose A.

Roman, J. Alberto San ^{[1
]}

Nadal, Maria Rosario Ortas

Gutierrez-Chico, Juan Luis

机构：

[1] Hosp Clin Univ Valladolid, CIBERCV, Valladolid, Spain

[2] Hosp Univ Miguel Servet, Zaragoza, Spain

[3] Shanghai Jiao Tong Univ, Sch Med, Ruijin Hosp, Dept Cardiovasc Med, Shanghai, Peoples R China

[4] Hosp Univ Virgen Arrixaca, Murcia, Spain

[5] Hosp Univ Princesa, Dept Cardiol, IIS IP Madrid, Madrid, Spain

[6] Complejo Hosp Navarra Pamplona, Pamplona, Spain

[7] Hosp Gen Univ Ciudad Real, Ciudad Real, Spain

[8] Complejo Asistencial Univ Leon, Leon, Spain

[9] Hosp Clin Univ Lozano Blesa, Zaragoza, Spain

[10] Bundeswehrzentralkrankenhaus, Koblenz, Germany

[11] Hosp Clin Univ Valladolid, Valladolid, Spain

来源：

INTERNATIONAL JOURNAL OF CARDIOLOGY | 2023年 / 389卷

关键词：

Quantitative flow ratio; Coronary physiology; Computational physiology; Coronary heart disease; DIAGNOSTIC-ACCURACY; MEDICAL THERAPY; RESERVE; ANGIOGRAPHY; STENOSIS; SEVERITY; EVENTS; LESIONS; BURDEN; FAVOR;

D O I：

10.1016/j.ijcard.2023.131176

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives: Confirming the prognostic value of global QFR and evaluating the long-term prognosis of QFRconcordant therapy in stable coronary artery disease.Background: Wire-based functional evaluation of coronary disease is linked to patient's prognosis. Quantitative Flow Ratio (QFR) is a newer index of computational physiology, linked to clinical outcomes and prognosis at 1 year follow-up. Long-term prognosis of QFR-concordant revascularization in stable coronary artery disease is however unknown hitherto.Methods: Consecutive patients with stable coronary disease undergoing coronary angiography were included. Centralized and blinded QFR analysis of three coronary territories was performed. Three vessel QFR (3vQFR) was defined as the sum of the basal QFR of each coronary territory. QFR-concordant revascularization was met if all significant lesions (QFR <= 0.80) were revascularized and all non-significant lesions (QFR > 0.80) were not; otherwise, the case was defined as QFR-discordant revascularization. Patient-oriented composite end-point (POCE) of cardiac death, myocardial infarction and unscheduled revascularization was the primary endpoint. Results: A total of 803 patients from six high-volume centers were included. Canadian Cardiovascular Society (CCS) class II angina was the most frequent (48.9%) clinical presentation. Median of follow-up was 68.8 months. 3vQFR was an independent predictor of POCE (HR 1.79 CI95% 1.01-3.18), with 2.75 as optimal cut-off value, irrespective of the therapy received. QFR-discordant revascularization (QFR+/Revascularization- or QFR-/ Revascularization+) was an independent predictor of POCE in multivariate analysis (HR 1.65, CI 95% 1.03-2.64).Conclusion: Global burden of epicardial coronary atherosclerosis, as evaluated by 3vQFR, as well as QFRdiscordant therapy are independent predictors of adverse clinical outcome at long-term follow-up in stable coronary artery disease.

引用

页数：7

共 42 条

[1] Angiography-Derived Fractional Flow Reserve in the SYNTAX II Trial Feasibility, Diagnostic Performance of Quantitative Flow Ratio, and Clinical Prognostic Value of Functional SYNTAX Score Derived From Quantitative Flow Ratio in Patients With 3-Vessel Disease [J].

Asano, Taku ;

Katagiri, Yuki ;

Chang, Chun Chin ;

Kogame, Norihiro ;

Chichareon, Ply ;

Takahashi, Kuniaki ;

Modolo, Rodrigo ;

Tenekecioglu, Erhan ;

Collet, Carlos ;

Jonker, Hans ;

Appleby, Clare ;

Zaman, Azfar ;

van Mieghem, Nicolas ;

Uren, Neal ;

Zueco, Javier ;

Piek, Jan J. ;

Reiber, Johan H. C. ;

Farooq, Vasim ;

Escaned, Javier ;

Banning, Adrian P. ;

Serruys, Patrick W. ;

Onuma, Yoshinobu .

JACC-CARDIOVASCULAR INTERVENTIONS, 2019, 12 (03) :259-270

[2] Fractional flow reserve to determine the appropriateness of angioplasty in moderate coronary stenosis - A randomized trial [J].

Bech, GJW ;

De Bruyne, S ;

Pijls, NHJ ;

de Muinck, ED ;

Hoorntje, JC ;

Escaned, J ;

Stella, PR ;

Boersma, E ;

Bartunek, J ;

Koolen, JJ ;

Wijns, W .

CIRCULATION, 2001, 103 (24) :2928-2934

[3] Optimal medical therapy with or without PCI for stable coronary disease [J].

Boden, William E. ;

O'Rourke, Robert A. ;

Teo, Koon K. ;

Hartigan, Pamela M. ;

Maron, David J. ;

Kostuk, William J. ;

Knudtson, Merril ;

Dada, Marcin ;

Casperson, Paul ;

Harris, Crystal L. ;

Chaitman, Bernard R. ;

Shaw, Leslee ;

Gosselin, Gilbert ;

Nawaz, Shah ;

Title, Lawrence M. ;

Gau, Gerald ;

Blaustein, Alvin S. ;

Booth, David C. ;

Bates, Eric R. ;

Spertus, John A. ;

Berman, Daniel S. ;

Mancini, G. B. John ;

Weintraub, William S. ;

Boden, W. ;

O'Rourke, R. ;

Teo, K. ;

Hartigan, P. ;

Weintraub, W. ;

Maron, D. ;

Mancini, J. ;

Weintraub, W. ;

Boden, W. ;

O'Rourke, R. ;

Teo, K. ;

Hartigan, P. ;

Knudtson, M. ;

Maron, D. ;

Bates, E. ;

Blaustein, A. ;

Booth, D. ;

Carere, R. ;

Ellis, S. ;

Gosselin, G. ;

Gau, G. ;

Jacobs, A. ;

King, S., III ;

Kostuk, W. ;

Harris, C. ;

Spertus, J. ;

Peduzzi, P. .

NEW ENGLAND JOURNAL OF MEDICINE, 2007, 356 (15) :1503-1516

[4] Diagnostic performance of angiography-derived fractional flow reserve: a systematic review and Bayesian meta-analysis [J].

Collet, Carlos ;

Onuma, Yoshinobu ;

Sonck, Jeroen ;

Asano, Taku ;

Vandeloo, Bert ;

Kornowski, Ran ;

Tu, Shengxian ;

Westra, Jelmer ;

Holm, Niels R. ;

Xu, Bo ;

de Winter, Robbert J. ;

Tijssen, Jan G. ;

Miyazaki, Yosuke ;

Katagiri, Yuki ;

Tenekecioglu, Erhan ;

Modolo, Rodrigo ;

Chichareon, Ply ;

Cosyns, Bernard ;

Schoors, Daniel ;

Roosens, Bram ;

Lochy, Stijn ;

Argacha, Jean-Francois ;

van Rosendael, Alexandre ;

Bax, Jeroen ;

Reiber, Johan H. C. ;

Escaned, Javier ;

De Bruyne, Bernard ;

Wijns, William ;

Serruys, Patrick W. .

EUROPEAN HEART JOURNAL, 2018, 39 (35) :3314-+

[5] Agreement between Murray law-based quantitative flow ratio (μQFR) and three--dimensional quantitative flow ratio (3D-QFR) in non-selected angiographic stenosis: A multicenter study [J].

Cortes, Carlos ;

Liu, Lili ;

Berdin, Scarlet Luisa ;

Fernandez-Corredoira, Pablo M. ;

Zhang, Ruiyan ;

Schaefer, Ulrich ;

Lopez, Maria ;

Diarte, Jose A. ;

Tu, Shengxian ;

Gutierrez-Chico, Juan Luis .

CARDIOLOGY JOURNAL, 2022, 29 (03) :388-395

[6] ISCHEMIA trial: The long-awaited evidence to confirm our prejudices [J].

Cortes, Carlos ;

Johnson, Thomas W. ;

Silber, Sigmund ;

Buszman, Piotr P. ;

Poerner, Tudor C. ;

Lavarra, Francesco ;

Ibanez, Borja ;

Kim, Yongcheol ;

Mischke, Karl ;

Jaguszewski, Milosz ;

Luis Gutierrez-Chico, Juan .

CARDIOLOGY JOURNAL, 2020, 27 (04) :336-341

[7]

Cortés C, 2021, CATHETER CARDIO INTE, V97, P807, DOI [10.1002/ccd.28857, 10.33255/3161/783]

[8] Use of the Instantaneous Wave-free Ratio or Fractional Flow Reserve in PCI [J].

Davies, J. E. ;

Sen, S. ;

Dehbi, H. -M. ;

Al-Lamee, R. ;

Petraco, R. ;

Nijjer, S. S. ;

Bhindi, R. ;

Lehman, S. J. ;

Walters, D. ;

Sapontis, J. ;

Janssens, L. ;

Vrints, C. J. ;

Khashaba, A. ;

Laine, M. ;

Van Belle, E. ;

Krackhardt, F. ;

Bojara, W. ;

Going, O. ;

Harle, T. ;

Indolfi, C. ;

Niccoli, G. ;

Ribichini, F. ;

Tanaka, N. ;

Yokoi, H. ;

Takashima, H. ;

Kikuta, Y. ;

Erglis, A. ;

Vinhas, H. ;

Silva, P. Canas ;

Baptista, S. B. ;

Alghamdi, A. ;

Hellig, F. ;

Koo, B. -K. ;

Nam, C. -W. ;

Shin, E. -S. ;

Doh, J. -H. ;

Brugaletta, S. ;

Alegria-Barrero, E. ;

Meuwissen, M. ;

Piek, J. J. ;

van Royen, N. ;

Sezer, M. ;

Di Mario, C. ;

Gerber, R. T. ;

Malik, I. S. ;

Sharp, A. S. P. ;

Talwar, S. ;

Tang, K. ;

Samady, H. ;

Altman, J. .

NEW ENGLAND JOURNAL OF MEDICINE, 2017, 376 (19) :1824-1834

[9] Fractional Flow Reserve-Guided PCI versus Medical Therapy in Stable Coronary Disease [J].

De Bruyne, Bernard ;

Pijls, Nico H. J. ;

Kalesan, Bindu ;

Barbato, Emanuele ;

Tonino, Pim A. L. ;

Piroth, Zsolt ;

Jagic, Nikola ;

Mobius-Winckler, Sven ;

Rioufol, Gilles ;

Witt, Nils ;

Kala, Petr ;

MacCarthy, Philip ;

Engstrom, Thomas ;

Oldroyd, Keith G. ;

Mavromatis, Kreton ;

Manoharan, Ganesh ;

Verlee, Peter ;

Frobert, Ole ;

Curzen, Nick ;

Johnson, Jane B. ;

Jueni, Peter ;

Fearon, William F. .

NEW ENGLAND JOURNAL OF MEDICINE, 2012, 367 (11) :991-1001

[10] Instantaneous Wave-free Ratio versus Fractional Flow Reserve to Guide PCI [J].

Gotberg, M. ;

Christiansen, E. H. ;

Gudmundsdottir, I. J. ;

Sandhall, L. ;

Danielewicz, M. ;

Jakobsen, L. ;

Olsson, S. -E. ;

Ohagen, P. ;

Olsson, H. ;

Omerovic, E. ;

Calais, F. ;

Lindroos, P. ;

Maeng, M. ;

Todt, T. ;

Venetsanos, D. ;

James, S. K. ;

Karegren, A. ;

Nilsson, M. ;

Carlsson, J. ;

Hauer, D. ;

Jensen, J. ;

Karlsson, A. -C. ;

Panayi, G. ;

Erlinge, D. ;

Frobert, O. .

NEW ENGLAND JOURNAL OF MEDICINE, 2017, 376 (19) :1813-1823

← 1 2 3 4 5 →