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Liu W, Cai H, Zheng Y, Wen Y, Chen S, Xie X, Zeng H, Zhu H, Ni Z, Pei F, Cao J, Cao G. Predictive Value of Post-Percutaneous Coronary Intervention Quantitative Flow Ratio for Vessel-Oriented Composite Endpoint. J Interv Cardiol 2023; 2023:2438347. [PMID: 37720628 PMCID: PMC10505082 DOI: 10.1155/2023/2438347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 08/08/2023] [Accepted: 08/31/2023] [Indexed: 09/19/2023] Open
Abstract
At present, there is a lack of indicators, which can accurately predict the post-percutaneous coronary intervention (post-PCI) vessel-oriented composite endpoint (VOCE). Recent studies showed that the post-PCI quantitative flow ratio (QFR) can predict post-PCI VOCE. PubMed, Embase, and Cochrane were searched from inception to March 27, 2022, and the cohort studies about that the post-PCI QFR predicts post-PCI VOCE were screened. Meta-analysis was performed, including 6 studies involving 4518 target vessels. The results of the studies included in this meta-analysis all showed that low post-PCI QFR was an independent risk factor for post-PCI VOCE after adjusting for other factors, HR (95% CI) ranging from 2.718 (1.347-5.486) to 6.53 (2.70-15.8). Our meta-analysis showed that the risk of post-PCI VOCE was significantly higher in the lower post-PCI QFR group than in the higher post-PCI QFR group (HR: 4.14, 95% CI: 3.00-5.70, P < 0.001, I2 = 27.9%). Post-PCI QFR has a good predictive value for post-PCI VOCE. Trial Registration. This trial is registered with CRD42022322001.
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Affiliation(s)
- Weibin Liu
- Department of Cardiology, Ganzhou People's Hospital, Ganzhou 341000, China
| | - Huaxiu Cai
- Department of Cardiology, Ganzhou People's Hospital, Ganzhou 341000, China
| | - Yin Zheng
- Gannan Medical University, Ganzhou 341000, China
| | - Yongkang Wen
- Gannan Medical University, Ganzhou 341000, China
| | - Sicheng Chen
- Gannan Medical University, Ganzhou 341000, China
| | - Xiuying Xie
- Department of General Practice, Ganzhou Hospital of Guangdong Provincial People's Hospital, Ganzhou Municipal Hospital, Ganzhou 341000, China
| | - Huan Zeng
- Department of Radiology and Imaging, Ganzhou Hospital of Guangdong Provincial People's Hospital, Ganzhou Municipal Hospital, Ganzhou 341000, China
| | - Hengqing Zhu
- Department of Cardiology, Ganzhou Hospital of Guangdong Provincial People's Hospital, Ganzhou Municipal Hospital, Ganzhou 341000, China
| | - Zhonghan Ni
- Department of Cardiology, Ganzhou Hospital of Guangdong Provincial People's Hospital, Ganzhou Municipal Hospital, Ganzhou 341000, China
| | - Fang Pei
- Department of Cardiology, Ganzhou Hospital of Guangdong Provincial People's Hospital, Ganzhou Municipal Hospital, Ganzhou 341000, China
| | - Jun Cao
- Department of Cardiology, Ganzhou Hospital of Guangdong Provincial People's Hospital, Ganzhou Municipal Hospital, Ganzhou 341000, China
| | - Gang Cao
- Department of Cardiology, Ganzhou Hospital of Guangdong Provincial People's Hospital, Ganzhou Municipal Hospital, Ganzhou 341000, China
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Terentes-Printzios D, Gkini KP, Oikonomou D, Gardikioti V, Aznaouridis K, Dima I, Tsioufis K, Vlachopoulos C. Prognostic Value of Post-PCI Angiography-Derived Fractional Flow Reserve: A Systematic Review and Meta-Analysis of Cohort Studies. J Pers Med 2023; 13:1251. [PMID: 37623501 PMCID: PMC10455379 DOI: 10.3390/jpm13081251] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
The post-percutaneous coronary intervention (post-PCI) fractional flow reserve (FFR) can detect suboptimal PCI or residual ischemia and potentially lead to fewer adverse clinical outcomes. We sought to investigate the predictive value of the angiography-derived FFR for adverse cardiovascular events in patients after PCI. We conducted a comprehensive search of electronic databases, MEDLINE, EMBASE, and the Cochrane Library, for studies published until March 2023 that investigated the prognostic role of angiography-derived fractional flow reserve values after PCI. We investigated the best predictive ability of the post-PCI angiography-derived FFR and relative risk (RR) estimates with 95% confidence intervals (CIs) between post-PCI angiography-derived FFR values and adverse events. Thirteen cohort studies involving 6961 patients (9719 vascular lesions; mean follow-up: 2.2 years) were included in this meta-analysis. The pooled HR of the studies using specific cut-off points for post-PCI angiography-derived FFR was 4.13 (95% CI, 2.92-5.82) for total cardiovascular events, while the pooled HRs for target vessel revascularization, cardiac death, target vessel myocardial infarction, and target lesion revascularization were 6.87 (95% CI, 4.93-9.56), 6.17 (95% CI, 3.52-10.80), 3.98 (95% CI, 2.37-6.66) and 6.27 (95% CI, 3.08-12.79), respectively. In a sensitivity analysis of three studies with 1789 patients assessing the predictive role of the post-PCI angiography-derived FFR as a continuous variable, we found a 58% risk reduction for future adverse events per 0.1 increase in the post-PCI angiography-derived FFR value. In conclusion, post-PCI angiography-derived FFR is an effective tool for predicting adverse cardiovascular events and could be potentially used in decision making, both during PCI and in the long-term follow-up.
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Zheng B, Yi T, Wu Q, Bai F, Li J. Drug-Coated Balloon Treatment for Possible Sequelae of Kawasaki Disease Evaluated by Multi-Modalities. Int Heart J 2022; 63:773-776. [PMID: 35831142 DOI: 10.1536/ihj.21-593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The most devastating sequela of Kawasaki disease (KD) is coronary artery complications that may lead to myocardial infarction and cardiac mortality. Percutaneous coronary intervention (PCI) and bypass grafting are recommended for KD patients with inducible myocardial ischemia and amendable coronary anatomy. However, there are few reports about coronary revascularization with drug-eluting balloons among KD patients, especially at an early age. We present a case report of multi-modality guidance of PCI with a drug-coated balloon (DCB) for a young patient with acute coronary syndrome and a history of KD. Post-procedural optical coherence tomography, angiography-derived fractional flow reserve, and 12-month coronary artery magnetic resonance showed favorable outcomes. The present case indicated that DCB therapy with intravascular imaging and physiologic assessment guidance may be an alternative strategy to treat severe coronary artery stenosis in selected patients with KD.
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Affiliation(s)
- Bo Zheng
- Peking University First Hospital
| | - Tieci Yi
- Peking University First Hospital
| | - Qiang Wu
- Lanzhou University Second Hospital
| | - Feng Bai
- Lanzhou University Second Hospital
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Kirigaya H, Okada K, Hibi K, Maejima N, Iwahashi N, Matsuzawa Y, Minamimoto Y, Kosuge M, Ebina T, Tamura K, Kimura K. Post-procedural quantitative flow ratio gradient and target lesion revascularization after drug-coated balloon or plain-old balloon angioplasty. J Cardiol 2022; 80:511-517. [DOI: 10.1016/j.jjcc.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/20/2022] [Accepted: 06/29/2022] [Indexed: 10/16/2022]
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