Characterization of real-world patients with low fractional flow reserve immediately after drug-eluting stents implantation

被引：19

作者：

Kimura Y. ^{[1
]}

Tanaka N. ^{[1
]}

Okura H. ^{[2
]}

Yoshida K. ^{[2
]}

Akabane M. ^{[3
]}

Takayama T. ^{[3
]}

Hirayama A. ^{[3
]}

Tada T. ^{[4
]}

Kimura T. ^{[4
]}

Takano H. ^{[5
]}

Mizuno K. ^{[5
]}

Inami T. ^{[6
]}

Yoshino H. ^{[6
]}

Yamashina A. ^{[1
]}

机构：

[1] Department of Cardiology, Tokyo Medical University, 6-7-1, Nishi-Shinjuku, Shinjuku-ku, Tokyo

[2] Department of Cardiology, Kawasaki Medical School, Okayama

[3] Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo

[4] Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto

[5] Department of Cardiovascular Medicine, Nippon Medical School, Tokyo

[6] Second Department of Internal Medicine, Kyorin University School of Medicine, Tokyo

来源：

Cardiovascular Intervention and Therapeutics | 2016年 / 31卷 / 1期

关键词：

Drug-eluting stent; Fractional flow reserve; Intravascular ultrasound; Percutaneous coronary intervention; Target vessel;

D O I：

10.1007/s12928-015-0342-4

中图分类号：

学科分类号：

摘要：

Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) for coronary artery disease has been validated. The present study aimed to identify the variables that influence FFR immediately after drug-eluting stents (DESs) implantation. We retrospectively analyzed 167 patients, who had been implanted with DESs at 6 Japanese institutions and had obtained the FFR values before and immediately after PCI. Intravascular ultrasound (IVUS) was used to build a PCI strategy and to decide the completion of the PCI procedure in all case. Patients were categorized into the following 2 groups according to FFR after PCI: the low FFR (≤0.80) group and the high FFR (>0.80) group. Despite successful PCI evaluated by coronary angiography and IVUS, 18.6 % of real-world patients were in the low FFR group. The proportion of the left anterior descending artery (LAD) was significantly greater in the low FFR group than in the high FFR group (87.1 vs 56.6 %; P < 0.01). Multivariate logistic regression analysis revealed that the LAD-to-non-LAD odds ratio for a low FFR (≤0.80) was 7.34 (95 % CI 1.63–32.95; P < 0.01) after adjustment for FFR value before PCI, suggesting that it is difficult to improve the hemodynamics of the LAD lesions even after successful PCI. The LAD was the strongest contributor to the inadequate recovery of FFR immediately after PCI, thus eliciting heed when treating the LAD lesions. © 2015, Japanese Association of Cardiovascular Intervention and Therapeutics.

引用

页码：29 / 37

页数：8

共 29 条

[1]

Bech G.J., De Bruyne B., Pijls N.H., de Muick E.D., Horne J.C., Escaped J., Et al., Fractional flow reserve to determine the appropriateness of angioplasty in moderate coronary stenosis: a randomized trial, Circulation, 103, pp. 2928-2934, (2001)

[2]

Pijls N.H., van Schaardenburgh P., Manoharan G., Boersma E., Bech J.W., vant Veer M., Et al., Percutaneous coronary intervention of functionally nonsignificant stenosis: 5-year follow-up of the DEFER study, J Am Coll Cardiol, 49, pp. 2105-2111, (2007)

[3]

Tonino P.A., De Bruyne B., Pijls N.H., Siebert U., Ikeno F., van' t Veer M., FAME Study Investigators. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention, N Engl J Med, 360, pp. 213-224, (2009)

[4]

Pijls N.H., Fearon W.F., Tonino P.A., Siebert U., Ikeno F., Bornschein B., FAME Study Investigators. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention in patients with multivessel coronary artery disease. 2-year follow-up of the FAME study, J Am Coll Cardiol, 56, pp. 177-184, (2010)

[5]

De Bruyne B., Pijls N.H., Kalesan B., Barbato E., Tonino P.A., Piroth Z., Et al., Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease, N Engl J Med, 67, pp. 991-1001, (2012)

[6]

Pijls N.H., Klauss V., Siebert U., Powers E., Takazawa K., Fearon W.F., Et al., Coronary pressure measurement after stenting predicts adverse events at follow-up: a multicenter registry, Circulation, 105, pp. 2950-2954, (2002)

[7]

Ishii H., Kataoka T., Kobayashi Y., Tsumori T., Takeshita H., Matsumoto R., Et al., Utility of myocardial fractional flow reserve for prediction of restenosis following sirolimus-eluting stent implantation, Heart Vessel, 26, pp. 572-581, (2011)

[8]

Nam C.W., Hur S.H., Cho Y.K., Park H.S., Yoon H.J., Kim H., Et al., Relation of fractional flow reserve after drug-eluting stent implantation to one-year outcomes, Am J Cardiol, 107, pp. 1763-1767, (2011)

[9]

Pijls N.H., Fractional flow reserve to guide coronary revascularization, Circ J, 77, pp. 561-569, (2013)

[10]

Shiono Y., Kubo T., Tanaka A., Ino Y., Yamaguchi T., Tanimoto T., Et al., Long-Term Outcome After Deferral of Revascularization in Patients With Intermediate Coronary Stenosis and Gray-Zone Fractional Flow Reserve, Circ J, 79, pp. 91-95, (2015)

← 1 2 3 →