دورية أكاديمية
أعرض في EDS

Angiographic Findings and Post-Percutaneous Coronary Intervention Fractional Flow Reserve.

التفاصيل البيبلوغرافية
العنوان: Angiographic Findings and Post-Percutaneous Coronary Intervention Fractional Flow Reserve.
المؤلفون: Zhang J; Department of Cardiology, Second Affiliated Hospital of Zhejiang University School of Medicine, State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China., Hwang D; Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea., Yang S; Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea., Hu X; Department of Cardiology, Second Affiliated Hospital of Zhejiang University School of Medicine, State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China., Lee JM; Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea., Nam CW; Department of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Korea., Shin ES; Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea., Doh JH; Department of Cardiology, Inje University Ilsan Paik Hospital, Goyang, Korea., Hoshino M; Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, Japan., Hamaya R; Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, Japan., Kanaji Y; Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, Japan., Murai T; Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, Japan., Zhang JJ; Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China., Ye F; Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China., Li X; Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China., Ge Z; Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China., Chen SL; Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China., Kakuta T; Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, Japan., Wang J; Department of Cardiology, Second Affiliated Hospital of Zhejiang University School of Medicine, State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China., Koo BK; Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea.
المصدر: JAMA network open [JAMA Netw Open] 2024 Jun 03; Vol. 7 (6), pp. e2418072. Date of Electronic Publication: 2024 Jun 03.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: American Medical Association Country of Publication: United States NLM ID: 101729235 Publication Model: Electronic Cited Medium: Internet ISSN: 2574-3805 (Electronic) Linking ISSN: 25743805 NLM ISO Abbreviation: JAMA Netw Open Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Chicago, IL : American Medical Association, [2018]-
مواضيع طبية MeSH: Fractional Flow Reserve, Myocardial*/physiology , Percutaneous Coronary Intervention*/methods , Coronary Angiography*, Humans ; Male ; Female ; Middle Aged ; Aged ; Coronary Artery Disease/physiopathology ; Coronary Artery Disease/surgery ; Coronary Artery Disease/diagnostic imaging ; Registries ; Drug-Eluting Stents ; Cohort Studies ; Republic of Korea ; China/epidemiology ; Treatment Outcome
مستخلص: Importance: The associations between angiographic findings and post-percutaneous coronary intervention (PCI) fractional flow reserve (FFR) and their clinical relevance according to residual functional disease burden have not been thoroughly investigated.
Objectives: To evaluate the association of angiographic and physiologic parameters according to residual functional disease burden after drug-eluting stent implantation.
Design, Setting, and Participants: This cohort study population was from the International Post-PCI FFR registry, which incorporated 4 registries from Korea, China, and Japan. Patients who underwent angiographically successful second-generation drug-eluting stent implantation and post-PCI FFR measurement were included in the analysis. The patients were divided into 3 groups according to the residual disease burden (post-PCI FFR ≤0.80 [residual ischemia], 0.81-0.86 [suboptimal], and >0.86 [optimal]). The data were collected from August 23, 2018, to June 11, 2019, and the current analysis was performed from January 11, 2022, to October 7, 2023.
Exposures: Angiographic parameters and post-PCI FFR.
Main Outcomes and Measures: The primary outcome was target vessel failure (TVF), defined as a composite of cardiac death, target vessel-related myocardial infarction, and target vessel revascularization (TVR) at 2 years.
Results: In this cohort of 2147 patients, the mean (SD) age was 64.3 (10.0) years, and 1644 patients (76.6%) were men. Based on the post-PCI physiologic status, 269 patients (12.5%) had residual ischemia, 551 (25.7%) had suboptimal results, and 1327 (61.8%) had optimal results. Angiographic parameters had poor correlations with post-PCI FFR (r < 0.20). Post-PCI FFR was isolated from all angiographic parameters in the unsupervised hierarchical cluster analysis. Post-PCI FFR was associated with the occurrence of TVF (adjusted hazard ratio [AHR] per post-PCI FFR 0.01 increase, 0.94 [95% CI, 0.92-0.97]; P < .001), but angiographic parameters were not. The residual ischemia group had a significantly higher rate of TVF than the suboptimal group (AHR, 1.75 [95% CI, 1.08-2.83]; P = .02) and the optimal group (AHR, 2.94 [95% CI, 1.82-4.73]; P < .001). The TVR in the residual ischemia group was predominantly associated with TVR in the nonstented segment (14 [53.8%]), unlike the other 2 groups (3 [10.0%] in the suboptimal group and 13 [30.2%] in the optimal group).
Conclusions and Relevance: In this cohort study of the International Post-PCI FFR registry, a low degree of associations were observed between angiographic and physiologic parameters after PCI. Post-PCI FFR, unlike angiographic parameters, was associated with clinical events and the distribution of clinical events. The current study supports the use of post-PCI FFR as a procedural quality metric and further prospective study is warranted.
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تواريخ الأحداث: Date Created: 20240621 Date Completed: 20240621 Latest Revision: 20240624
رمز التحديث: 20240624
مُعرف محوري في PubMed: PMC11193130
DOI: 10.1001/jamanetworkopen.2024.18072
PMID: 38904958
قاعدة البيانات: MEDLINE
الوصف
تدمد:2574-3805
DOI:10.1001/jamanetworkopen.2024.18072