PDF(Pubmed)
Abstract：
UNASSIGNED: 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.
UNASSIGNED: To evaluate the association of angiographic and physiologic parameters according to residual functional disease burden after drug-eluting stent implantation.
UNASSIGNED: 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.
UNASSIGNED: Angiographic parameters and post-PCI FFR.
UNASSIGNED: 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.
UNASSIGNED: 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).
UNASSIGNED: 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.
UNASSIGNED: To evaluate the association of angiographic and physiologic parameters according to residual functional disease burden after drug-eluting stent implantation.
UNASSIGNED: 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.
UNASSIGNED: Angiographic parameters and post-PCI FFR.
UNASSIGNED: 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.
UNASSIGNED: 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).
UNASSIGNED: 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.
摘要：
■血管造影结果与经皮冠状动脉介入治疗（PCI）后血流储备分数（FFR）之间的关系及其根据残留功能性疾病负担的临床相关性尚未得到彻底研究。
■根据药物洗脱支架植入后残留的功能性疾病负荷，评估血管造影和生理参数的相关性。
■该队列研究人群来自国际PCI后FFR注册，合并了来自韩国的4个登记册，中国,和日本。接受血管造影成功的第二代药物洗脱支架植入和PCI后FFR测量的患者被纳入分析。根据残余疾病负担将患者分为3组(PCI术后FFR≤0.80[残余缺血],0.81-0.86[次优]，和>0.86[最优])。数据收集时间为2018年8月23日至2019年6月11日，当前分析时间为2022年1月11日至2023年10月7日。
■血管造影参数和PCI术后FFR。
■主要结果是目标血管衰竭（TVF），定义为心脏死亡的复合物，靶血管相关心肌梗死,和目标血管血运重建（TVR）在2年。
■在这个2147名患者的队列中，平均（SD）年龄为64.3（10.0）岁，1644例(76.6%)为男性。根据PCI术后的生理状况，269例（12.5%）有残余缺血，551(25.7%)的结果不理想，1327（61.8%）的结果最优。血管造影参数与PCI术后FFR相关性较差(r<0.20)。在无监督分层聚类分析中，PCI后FFR与所有血管造影参数分离。PCI术后FFR与TVF的发生相关(PCI术后FFR每增加0.01校正风险比[AHR],0.94[95%CI，0.92-0.97]；P<.001)，但血管造影参数没有。残余缺血组的TVF发生率明显高于次优组（AHR，1.75[95%CI，1.08-2.83]；P=.02)和最优组(AHR，2.94[95%CI，1.82-4.73]；P<.001）。残余缺血组的TVR主要与非支架段的TVR相关（14[53.8%]），与其他2组不同（次优组中3[10.0％]，最优组中13[30.2％]）。
■在这项国际PCI后FFR注册的队列研究中，PCI术后血管造影和生理参数之间的相关性较低.PCI后FFR,与血管造影参数不同，与临床事件和临床事件的分布相关。目前的研究支持使用PCI术后FFR作为程序质量指标，需要进一步的前瞻性研究。
■根据药物洗脱支架植入后残留的功能性疾病负荷，评估血管造影和生理参数的相关性。
■该队列研究人群来自国际PCI后FFR注册，合并了来自韩国的4个登记册，中国,和日本。接受血管造影成功的第二代药物洗脱支架植入和PCI后FFR测量的患者被纳入分析。根据残余疾病负担将患者分为3组(PCI术后FFR≤0.80[残余缺血],0.81-0.86[次优]，和>0.86[最优])。数据收集时间为2018年8月23日至2019年6月11日，当前分析时间为2022年1月11日至2023年10月7日。
■血管造影参数和PCI术后FFR。
■主要结果是目标血管衰竭（TVF），定义为心脏死亡的复合物，靶血管相关心肌梗死,和目标血管血运重建（TVR）在2年。
■在这个2147名患者的队列中，平均（SD）年龄为64.3（10.0）岁，1644例(76.6%)为男性。根据PCI术后的生理状况，269例（12.5%）有残余缺血，551(25.7%)的结果不理想，1327（61.8%）的结果最优。血管造影参数与PCI术后FFR相关性较差(r<0.20)。在无监督分层聚类分析中，PCI后FFR与所有血管造影参数分离。PCI术后FFR与TVF的发生相关(PCI术后FFR每增加0.01校正风险比[AHR],0.94[95%CI，0.92-0.97]；P<.001)，但血管造影参数没有。残余缺血组的TVF发生率明显高于次优组（AHR，1.75[95%CI，1.08-2.83]；P=.02)和最优组(AHR，2.94[95%CI，1.82-4.73]；P<.001）。残余缺血组的TVR主要与非支架段的TVR相关（14[53.8%]），与其他2组不同（次优组中3[10.0％]，最优组中13[30.2％]）。
■在这项国际PCI后FFR注册的队列研究中，PCI术后血管造影和生理参数之间的相关性较低.PCI后FFR,与血管造影参数不同，与临床事件和临床事件的分布相关。目前的研究支持使用PCI术后FFR作为程序质量指标，需要进一步的前瞻性研究。
