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Abstract：
UNASSIGNED: The correlation between percutaneous coronary intervention (PCI)-related microvascular dysfunction (MVD) and plaque characteristics remains unclear. To investigate this correlation and its prognosis, we assessed changes in MVD by angiographic microvascular resistance (AMR) and intracoronary ultrasound scans after PCI.
UNASSIGNED: We conducted a retrospective study that enrolled 250 patients with coronary artery disease between July 2016 and December 2018. We collected demographic characteristics, laboratory tests, coronary angiography (CAG) and intracoronary ultrasound findings. We calculated quantitative flow ratio (QFR) and AMR by CAG. The endpoint was vessel-oriented composite outcomes (VOCOs).
UNASSIGNED: After 47 exclusions, we divided 203 cases into a deteriorated group (n=139) and an improved group (n=64) based on AMR change after PCI. Compared with the improved group, the deteriorated group had smaller lumen area [3.03 (interquartile range, 2.20-3.91) vs. 3.55 mm2 (interquartile range, 2.45-4.57), P=0.033], higher plaque burden [78.92% (interquartile range, 73.95-82.61%) vs. 71.93% (interquartile range, 62.70-77.51%), P<0.001], and higher proportion of lipidic components (13.86%±4.67% vs. 11.78%±4.41%, P=0.024). Of 186 patients who completed 4.81±1.55 years follow-up, 56 developed VOCOs. Receiver-operating characteristic (ROC) curve analysis showed post-PCI AMR and VOCOs correlation (area under the curve: 0.729, P<0.001). Multivariate regression analysis showed post-PCI AMR >285 mmHg·s/m correlated with adverse outcome (hazard ratio =4.350; 95% confidence interval: 1.95-9.703; P<0.001).
UNASSIGNED: Intravascular ultrasound (IVUS) imaging and AMR revealed an association of post-PCI MVD with a smaller lumen area, more severe plaque burden, and a higher percentage of lipidic components. Post-PCI MVD was an independent risk factor for poor prognosis.
UNASSIGNED: We conducted a retrospective study that enrolled 250 patients with coronary artery disease between July 2016 and December 2018. We collected demographic characteristics, laboratory tests, coronary angiography (CAG) and intracoronary ultrasound findings. We calculated quantitative flow ratio (QFR) and AMR by CAG. The endpoint was vessel-oriented composite outcomes (VOCOs).
UNASSIGNED: After 47 exclusions, we divided 203 cases into a deteriorated group (n=139) and an improved group (n=64) based on AMR change after PCI. Compared with the improved group, the deteriorated group had smaller lumen area [3.03 (interquartile range, 2.20-3.91) vs. 3.55 mm2 (interquartile range, 2.45-4.57), P=0.033], higher plaque burden [78.92% (interquartile range, 73.95-82.61%) vs. 71.93% (interquartile range, 62.70-77.51%), P<0.001], and higher proportion of lipidic components (13.86%±4.67% vs. 11.78%±4.41%, P=0.024). Of 186 patients who completed 4.81±1.55 years follow-up, 56 developed VOCOs. Receiver-operating characteristic (ROC) curve analysis showed post-PCI AMR and VOCOs correlation (area under the curve: 0.729, P<0.001). Multivariate regression analysis showed post-PCI AMR >285 mmHg·s/m correlated with adverse outcome (hazard ratio =4.350; 95% confidence interval: 1.95-9.703; P<0.001).
UNASSIGNED: Intravascular ultrasound (IVUS) imaging and AMR revealed an association of post-PCI MVD with a smaller lumen area, more severe plaque burden, and a higher percentage of lipidic components. Post-PCI MVD was an independent risk factor for poor prognosis.
摘要：
■经皮冠状动脉介入治疗（PCI）相关的微血管功能障碍（MVD）与斑块特征之间的相关性尚不清楚。为了研究这种相关性及其预后，我们通过PCI术后血管造影微血管阻力(AMR)和冠状动脉内超声扫描评估了MVD的变化.
■我们进行了一项回顾性研究，纳入了2016年7月至2018年12月的250名冠心病患者。我们收集了人口统计特征，实验室测试,冠状动脉造影（CAG）和冠状动脉内超声检查结果。我们通过CAG计算定量流量比（QFR）和AMR。终点是面向血管的综合结果(VOCO)。
■在47次排除之后，我们根据PCI术后AMR变化将203例患者分为恶化组(n=139)和改善组(n=64).与改进组相比，恶化组的管腔面积较小[3.03(四分位间距，2.20-3.91)vs.3.55mm2(四分位数间距,2.45-4.57),P=0.033],较高的斑块负荷[78.92%(四分位数间距，73.95-82.61%）与71.93%(四分位数间距，62.70-77.51%），P<0.001],脂质成分的比例更高(13.86%±4.67%vs.11.78%±4.41%,P=0.024)。186例完成4.81±1.55年随访的患者，56个已开发的VOCOs。受试者工作特征(ROC)曲线分析显示PCI术后AMR与VOCOs存在相关性(曲线下面积0.729,P<0.001)。多因素回归分析显示，PCI术后AMR>285mmHg·s/m与不良预后相关（风险比=4.350；95%置信区间：1.95～9.703；P<0.001）。
■血管内超声（IVUS）成像和AMR显示PCI术后MVD与较小的管腔面积有关，更严重的斑块负担，和较高比例的脂质成分。PCI术后MVD是预后不良的独立危险因素。
■我们进行了一项回顾性研究，纳入了2016年7月至2018年12月的250名冠心病患者。我们收集了人口统计特征，实验室测试,冠状动脉造影（CAG）和冠状动脉内超声检查结果。我们通过CAG计算定量流量比（QFR）和AMR。终点是面向血管的综合结果(VOCO)。
■在47次排除之后，我们根据PCI术后AMR变化将203例患者分为恶化组(n=139)和改善组(n=64).与改进组相比，恶化组的管腔面积较小[3.03(四分位间距，2.20-3.91)vs.3.55mm2(四分位数间距,2.45-4.57),P=0.033],较高的斑块负荷[78.92%(四分位数间距，73.95-82.61%）与71.93%(四分位数间距，62.70-77.51%），P<0.001],脂质成分的比例更高(13.86%±4.67%vs.11.78%±4.41%,P=0.024)。186例完成4.81±1.55年随访的患者，56个已开发的VOCOs。受试者工作特征(ROC)曲线分析显示PCI术后AMR与VOCOs存在相关性(曲线下面积0.729,P<0.001)。多因素回归分析显示，PCI术后AMR>285mmHg·s/m与不良预后相关（风险比=4.350；95%置信区间：1.95～9.703；P<0.001）。
■血管内超声（IVUS）成像和AMR显示PCI术后MVD与较小的管腔面积有关，更严重的斑块负担，和较高比例的脂质成分。PCI术后MVD是预后不良的独立危险因素。
