Predictors and outcomes of ischemia-driven target lesion revascularization in deferred lesion based on fractional flow reserve: a multi-center retrospective cohort study

被引：2

作者：

Sato, Takao ^{[1
,2
,12
]}

Goto, Sonoka ^{[1
]}

Kishi, Shohei ^{[3
]}

Yamaguchi, Kohei ^{[4
]}

Warisawa, Takayuki ^{[5
]}

Kozuki, Amane ^{[6
]}

Toshihiro, Suga ^{[7
]}

Tsuchida, Keiichi ^{[8
]}

Yokoi, Hirokazu ^{[9
]}

Kazuya, Kawai ^{[1
,10
]}

Akazawa, Kohei ^{[11
]}

Aizawa, Yoshifusa ^{[1
]}

机构：

[1] Tachikawa Gen Hosp, Cardiol, Nagaoka, Japan

[2] Columbia Univ, NewYork Presbyterian Hosp, Cardiovasc Res Fdn, Clin Trials Ctr,Irving Med Ctr, New York, NY USA

[3] Tokyo Med Univ, Div Cardiol, Ibaraki Med Ctr, Ami, Ibaraki, Japan

[4] Niigata Prefectural Shibata Hosp, Div Cardiol, Shibara, Japan

[5] Hammersmith Hosp, Imperial Coll London, London, England

[6] Osaka Saiseikai Nakatsu Hosp, Div Cardiol, Osaka, Japan

[7] Gunma Chou Hosp, Div Cardiol, Maebashi, Gunma, Japan

[8] Niigata City Hosp, Div Cardiol, Niigata, Japan

[9] Rakuwakai Otowa Hosp, Dept Cardiol, Kyoto, Japan

[10] Chikamori Hosp, Dept Cardiol, Kochi, Japan

[11] Niigata Univ Med & Dent Hosp, Dept Med Informat, Niigata, Japan

[12] Tachikawa Gen Hosp, Cardiol, 561-1 Jyojyomachi Aza Yauchi, Nagaoka City, Japan

来源：

CARDIOVASCULAR DIAGNOSIS AND THERAPY | 2022年 / 12卷 / 04期

关键词：

Fractional flow reserve; SYNTAX score; in-stent restenosis; PERCUTANEOUS CORONARY INTERVENTION; FOLLOW-UP; ARTERY-DISEASE; MYOCARDIAL-INFARCTION; PRESSURE MEASUREMENT; ANGIOGRAPHY; STENOSIS; NEOATHEROSCLEROSIS; ANGIOPLASTY; ELEVATION;

D O I：

10.21037/cdt-21-773

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Fractional flow reserve (FFR) has become the gold standard for diagnosing ischemia in angiographically intermediate epicardial coronary artery stenosis. This study investigated the clinical outcomes and predictors of revascularization deferral based on FFR.Methods: In this retrospective cohort study, we assessed 474 lesions (440 patients) where revascularization was deferred based on the FFR value. Minimum lumen diameter and %-diameter stenosis were measured. Calcification was graded as none, mild, moderate, or heavy. The synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score I was also determined. The primary outcome was ischemia-driven target lesion revascularization (TLR) in deferred lesions within 3 years. Patients were also assigned into two groups based on FFR value.Results: The average age of the patients was 69.7 +/- 10.4 years. The average FFR value was 0.86 +/- 0.05. Stable angina pectoris was noted in 298 (67.7%) cases, and in-stent restenosis (ISR) was present in 28 (5.9%). The average SYNTAX score was 7.2 +/- 4.2. The 3-year ischemia-driven TLR was 18 lesions (3.8%). Cox proportional hazard model revealed that the SYNTAX score and ISR were independent predictors for TLR in deferred lesions [hazard ratio (HR) =1.10, 95% confidential interval (CI): 1.01-1.19, P=0.03; HR =6.33; 95% CI: 2.25-17.8, P<0.01, respectively]. The deferral group, with a low FFR value, tended to have higher TLR rates than other groups.Conclusions: Lesions with lower FFR values were associated with a higher incidence of ischemia-driven TLR than those with higher FFR values. SYNTAX score and ISR were predictors for ischemia-driven TLR at 3 years in the deferred lesions.

引用

页码：485 / 494

页数：10

共 41 条

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Zimmermann, Frederik M. ;

Ferrara, Angela ;

Johnson, Nils P. ;

van Nunen, Lokien X. ;

Escaned, Javier ;

Albertsson, Per ;

Erbel, Raimund ;

Legrand, Victor ;

Gwon, Hyeong-Cheol ;

Remkes, Wouter S. ;

Stella, Pieter R. ;

van Schaardenburgh, Pepijn ;

Bech, G. Jan Willem ;

De Bruyne, Bernard ;

Pijls, Nico H. J. .

EUROPEAN HEART JOURNAL, 2015, 36 (45) :3182-3188

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