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Yang Y, Song C, Jia L, Dong Q, Song W, Yin D, Dou K. Prognostic Value of Multiple Complete Blood Count-Derived Indices in Intermediate Coronary Lesions. Angiology 2023:33197231198678. [PMID: 37646226 DOI: 10.1177/00033197231198678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Complete blood count (CBC)-derived indices have been proposed as reliable inflammatory biomarkers to predict outcomes in the context of coronary artery disease. These indices have yet to be thoroughly validated in patients with intermediate coronary stenosis. Our study included 1527 patients only with intermediate coronary stenosis. The examined variables were neutrophil-lymphocyte ratio (NLR), derived NLR, monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), systemic immune inflammation index (SII), system inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI). The primary endpoint was the composite of major adverse cardiovascular events (MACEs), including all-cause death, non-fatal myocardial infarction, and unplanned revascularization. Over a follow-up of 6.11 (5.73-6.55) years, MACEs occurred in 189 patients. Receiver operator characteristic curve analysis showed that SIRI outperformed other indices with the most significant area under the curve. In the multivariable analysis, SIRI (hazard ratio [HR] 1.588, 95% confidence interval [CI] 1.138-2.212) and AISI (HR 1.673, 95% CI 1.217-2.300) were the most important prognostic factors among all the indices. The discrimination ability of each index was strengthened in patients with less burden of modifiable cardiovascular risk factors. SIRI also exhibited the best incremental value beyond the traditional cardiovascular risk model.
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Affiliation(s)
- Yuxiu Yang
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Chenxi Song
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Lei Jia
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Qiuting Dong
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Weihua Song
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Dong Yin
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Kefei Dou
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Sun R, Ma R, Wang M, Han K, Zhang Z, Wang L, Fang W. Prognostic value of myocardial flow reserve derived by quantitative SPECT for patients with intermediate coronary stenoses. J Nucl Cardiol 2023; 30:1427-1436. [PMID: 36593332 DOI: 10.1007/s12350-022-03186-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 12/04/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Functional assessment of myocardial ischemia is critical for patients with intermediate coronary stenosis. As the diagnosis performance of absolute quantification of myocardial blood flow (MBF) and myocardial flow reserve (MFR) by single-photon emission tomography (SPECT) has been proven, its prognostic value in patients with intermediate coronary stenosis remains to be evaluated. METHODS Patients with one or more target lesions of ≥ 50% to ≤ 80% diameter stenoses on invasive coronary angiography were prospectively included in this study. All patients were scheduled for clinically indicated SPECT myocardial perfusion imaging (MPI) within 3 months and agreed to provide informed consent to participate in quantitative SPECT acquisitions to obtain MBF and MFR values. The primary endpoint was defined as a composite of the major adverse cardiac events (MACE): Cardiac death, myocardial infarction, late revascularization and heart failure or unstable angina-related rehospitalization. RESULTS One hundred and nineteen patients (mean age 57 ± 8 years, 62.2% men) were included in the analysis. The average lumen stenosis of patients was 67.0 ± 10.4%. Over a median follow-up duration of 1408 days (interquartile range 1297-1666 days), 18 patients (15.1%) had MACE. Patients with impaired MFR (MFR < 2) had a significantly higher incidence of events than those with preserved MFR (MFR ≥ 2) in Kaplan-Meier survival analysis (Log-rank = 8.105, P = 0.004), while no significant difference was found between patients with normal relative perfusion and those with relative perfusion abnormalities (log-rank = 0.098, P > 0.05). In a multivariate Cox hazards analysis, the SPECT-derived MFR remained an independent predictor of MACE (HR 0.352, 95% CI 0.145-0.854, P = 0.021). CONCLUSIONS In a cohort of patients with angiographic intermediate coronary lesions, SPECT-derived MFR was an independent predictor of prognosis.
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Affiliation(s)
- Ruoxi Sun
- Department of Nuclear Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, 167 Beilishi Road, Beijing, 100037, China
| | - Rongzheng Ma
- Department of Nuclear Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, 167 Beilishi Road, Beijing, 100037, China
| | - Meng Wang
- Department of Nuclear Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, 167 Beilishi Road, Beijing, 100037, China
| | - Kai Han
- Department of Nuclear Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, 167 Beilishi Road, Beijing, 100037, China
| | - Zongyao Zhang
- Department of Nuclear Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, 167 Beilishi Road, Beijing, 100037, China
| | - Lei Wang
- Department of Nuclear Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, 167 Beilishi Road, Beijing, 100037, China.
| | - Wei Fang
- Department of Nuclear Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, 167 Beilishi Road, Beijing, 100037, China.
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Nagasaka T, Amanai S, Ishibashi Y, Aihara K, Ohyama Y, Takama N, Koitabashi N, Ishii H. Long-term outcomes of intermediate coronary stenosis in patients undergoing hemodialysis after deferred revascularization based on fractional flow reserve. Catheter Cardiovasc Interv 2022; 100:971-978. [PMID: 36262079 DOI: 10.1002/ccd.30421] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/29/2022] [Accepted: 10/02/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVES This study aimed to assess the long-term outcomes of patients undergoing hemodialysis (HD) after deferred revascularization based on fractional flow reserve (FFR). BACKGROUND FFR is a practical technique for assessing the functional severity of intermediate coronary stenosis. Prior research has revealed a satisfactory outcome in patients after the deferral of percutaneous coronary intervention for coronary lesions based on FFR measurement. However, little research has been conducted focusing on patients undergoing HD. METHODS The retrospective study comprised 225 consecutive patients with FFR assessment and deferred revascularization between January 2016 and December 2019. Based on a deferral cutoff FFR value of >0.80, we assessed the differences in all-cause death, major adverse cardiac events (MACEs), and target vessel failure (TVF) between the HD (n = 69) and non-HD groups (n = 156) during a mean ± standard deviation routine follow-up of 32.2 ± 13.4 months. RESULTS Although the HD group had significantly higher rates of diabetes mellitus than the non-HD group (53.6% vs. 37.2%, p = 0.021), there were no significant differences in sex, left ventricular ejection fraction, or other risk factors between the groups, nor with respect to stenosis diameter or mean FFR. The HD group had a significantly higher incidence of TVF than the non-HD group (34.8% vs. 14.1%, p < 0.001), as well as a significantly higher risk of all-cause death and MACEs. CONCLUSIONS The study revealed that deferred revascularization in coronary lesions with an FFR value of >0.80 in patients undergoing HD was associated with poor outcomes. Therefore, it is important to carefully monitor patients with intermediate coronary stenosis undergoing HD.
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Affiliation(s)
- Takashi Nagasaka
- Department of Cardiovascular Medicine, Gunma University School of Medicine, Maebashi, Japan
| | - Shiro Amanai
- Department of Cardiovascular Medicine, Gunma University School of Medicine, Maebashi, Japan
| | - Yohei Ishibashi
- Department of Cardiovascular Medicine, Gunma University School of Medicine, Maebashi, Japan
| | - Kazufumi Aihara
- Department of Cardiovascular Medicine, Gunma University School of Medicine, Maebashi, Japan
| | - Yoshiaki Ohyama
- Department of Cardiovascular Medicine, Gunma University School of Medicine, Maebashi, Japan
| | - Noriaki Takama
- Department of Cardiovascular Medicine, Gunma University School of Medicine, Maebashi, Japan
| | - Norimichi Koitabashi
- Department of Cardiovascular Medicine, Gunma University School of Medicine, Maebashi, Japan
| | - Hideki Ishii
- Department of Cardiovascular Medicine, Gunma University School of Medicine, Maebashi, Japan
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Banerjee RK, Ramadurai S, Manegaonkar SM, Rao MB, Rakkimuthu S, Effat MA. Comparison Between 5- and 1-Year Outcomes Using Cutoff Values of Pressure Drop Coefficient and Fractional Flow Reserve for Diagnosing Coronary Artery Diseases. Front Physiol 2021; 12:689517. [PMID: 34335296 PMCID: PMC8317064 DOI: 10.3389/fphys.2021.689517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/28/2021] [Indexed: 12/02/2022] Open
Abstract
Background The current pressure-based coronary diagnostic index, fractional flow reserve (FFR), has a limited efficacy in the presence of microvascular disease (MVD). To overcome the limitations of FFR, the objective is to assess the recently introduced pressure drop coefficient (CDP), a fundamental fluid dynamics-based combined pressure–flow index. Methods We hypothesize that CDP will result in improved clinical outcomes in comparison to FFR. To test the hypothesis, chi-square test was performed to compare the percent major adverse cardiac events (%MACE) at 5 years between (a) FFR < 0.75 and CDP > 27.9 and (b) FFR < 0.80 and CDP > 25.4 groups using a prospective cohort study. Furthermore, Kaplan–Meier survival curves were compared between the FFR and CDP groups. The results were considered statistically significant for p < 0.05. The outcomes of the CDP arm were presumptive as clinical decision was solely based on the FFR. Results For the complete patient group, the %MACE in the CDP > 27.9 group (10 out of 35, 29%) was lower in comparison to the FFR < 0.75 group (11 out of 20, 55%), and the difference was near significant (p = 0.05). The survival analysis showed a significantly higher survival rate (p = 0.01) in the CDP > 27.9 group (n = 35) when compared to the FFR < 0.75 group (n = 20). The results remained similar for the FFR = 0.80 cutoff. The comparison of the 5-year MACE outcomes with the 1-year outcomes for the complete patient group showed similar trends, with a higher statistical significance for a longer follow-up period of 5 years. Conclusion Based on the MACE and survival analysis outcomes, CDP could possibly be an alternate diagnostic index for decision-making in the cardiac catheterization laboratory. Clinical Trial Registration www.ClinicalTrials.gov, identifier NCT01719016.
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Affiliation(s)
- Rupak K Banerjee
- Department of Mechanical and Materials Engineering, University of Cincinnati, Cincinnati, OH, United States.,Research Services, Veteran Affairs Medical Services, Cincinnati, OH, United States
| | - Sruthi Ramadurai
- Department of Mechanical and Materials Engineering, University of Cincinnati, Cincinnati, OH, United States
| | - Shreyash M Manegaonkar
- Department of Mechanical and Materials Engineering, University of Cincinnati, Cincinnati, OH, United States
| | - Marepalli B Rao
- Department of Environmental and Public Health Sciences, University of Cincinnati, Cincinnati, OH, United States
| | - Sathyaprabha Rakkimuthu
- Department of Mechanical and Materials Engineering, University of Cincinnati, Cincinnati, OH, United States
| | - Mohamed A Effat
- Department of Cardiology, University of Cincinnati Medical Center, Cincinnati, OH, United States
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Kleczyński P, Dziewierz A, Rzeszutko L, Dudek D, Legutko J. Is quantitative flow ratio enough to accurately assess intermediate coronary stenosis? A comparison study with fractional flow reserve. Cardiol J 2020; 26:793-795. [PMID: 31970737 DOI: 10.5603/cj.2019.0116] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 11/14/2019] [Accepted: 11/14/2019] [Indexed: 11/25/2022] Open
Affiliation(s)
| | - Artur Dziewierz
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 17 Kopernika St., 31-501, Krakow, Poland
| | - Lukasz Rzeszutko
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 17 Kopernika St., 31-501, Krakow, Poland
| | - Dariusz Dudek
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 17 Kopernika St., 31-501, Krakow, Poland
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TOPAL S, SEZENÖZ B, CANDEMİR M, AÇIKGÖZ E, AÇIKGÖZ SK, BOYACI NB. An old friend: uric acid and its association with fractional flow reserve. Turk J Med Sci 2019; 49:1614-1619. [PMID: 31655503 PMCID: PMC7518665 DOI: 10.3906/sag-1903-91] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 07/22/2019] [Indexed: 11/04/2022] Open
Abstract
Background/aim The aim of this study was to investigate the importance of preprocedural uric acid (UA) level in predicting fractional flow reserve (FFR) results of intermediate coronary lesions in patients with stable coronary artery disease undergoing coronary angiography. Materials and methods We retrospectively analyzed 293 patients who underwent FFR measurement to determine the significance of intermediate coronary stenosis detected by conventional coronary angiography. Patients were divided into 2 groups: Group 1 (n = 127) included patients with FFR of <0.80 (hemodynamically significant lesions), and Group 2 (n = 169) consisted of patients with FFR of >0.80 (hemodynamically nonsignificant lesions). Uric acid levels were assessed in both groups with the enzymatic colorimetric method by clinical chemistry autoanalyzer. Results The mean UA level was significantly higher in patients whose FFR indicated hemodynamically significant coronary lesions (UA: 5.43 ± 1.29 mg/dL in Group 1 vs. 4.51 ± 1.34 mg/dL in Group 2, P < 0.001). Conclusion Elevated UA levels are associated with hemodynamically significant coronary lesions measured with FFR. Uric acid may be used as a predictor of hemodynamically compromised coronary lesions before FFR procedures.
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Affiliation(s)
- Salih TOPAL
- Department of Cardiology, Faculty of Medicine, Gazi University, AnkaraTurkey
- * To whom correspondence should be addressed. E-mail:
| | - Burak SEZENÖZ
- Department of Cardiology, Faculty of Medicine, Gazi University, AnkaraTurkey
| | | | - Eser AÇIKGÖZ
- Department of Cardiology, Abdurrahman Yurtarslan Ankara Oncology Education and Research Hospital, AnkaraTurkey
| | - Sadık Kadri AÇIKGÖZ
- Department of Cardiology, Kahraman Kazan Hamdi Eriş State Hospital, KahramankazanTurkey
| | - Nuri Bülent BOYACI
- Department of Cardiology, Faculty of Medicine, Gazi University, AnkaraTurkey
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Xia G, Fan D, Yao X, Guan G, Wang J. Diagnostic efficacy of fractional flow reserve with coronary angiography in dual-source computed tomography scanner. Acta Cardiol 2018; 73:76-83. [PMID: 28830299 DOI: 10.1080/00015385.2017.1335037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The management of patients with intermediate coronary lesions is a major clinical issue. Fractional flow reserve (FFR) is considered the gold criterion for the assessment of ischaemic stenosis, but it requires an invasive procedure. Coronary computed tomography angiography (CTA) for fractional flow reserve (FFRCT) is a novel noninvasive alternative for the diagnosis of ischaemic lesions. The aim was to determine the diagnostic efficacy of FFRCT for ischaemic coronary artery stenosis lesions of intermediate severity. METHODS A total of 129 patients underwent 64-row dual-source CTA and invasive coronary angiography (ICA). In all, 156 vessels were identified as intermediate-grade coronary artery stenosis by subsequent ICA, defined as a maximum diameter reduction of 50%-70%. The FFR was also measured during ICA. FFRCT was computed from the three-dimensional dual-source CTA model and coronary flow dynamics data. RESULTS Per-patient diagnostic sensitivity, specificity, positive predictive values, negative predictive values and accuracy of FFRCT amounted to 89.2%, 81.5%, 66.0%, 94.9% and 83.7%, respectively; and 86.9%, 73.6%, 58.0%, 93.1% and 77.6% on the per-vessel basis, respectively. FFRCT and FFR showed a good positive correlation. Bland-Altman analysis displayed good concordance between FFRCT and FFR. The receiver operating characteristic curve revealed that the area under the curve of FFRCT was 0.918 (95% confidence interval 0.849-0.986) on the per-patient analysis and 0.916 (95% confidence interval 0.863-0.969) on per-vessel analysis, respectively. CONCLUSIONS FFRCT is featured by moderate accuracy in discriminating lesions of intermediate coronary artery stenosis that cause myocardial ischaemia. Impact statement How to treat intermediate coronary stenosis represents a major clinical issue. FFRCT has recently emerged as a novel noninvasive method evaluating ischemic lesions. In this study, we defined such lesion as 50-70% diameter stenosis. We designed the study to assess the diagnostic efficacy of FFRCT both at per-vessel level and at per-vessel levels for ischemic lesions.
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Affiliation(s)
- Guozhi Xia
- Department of Cardiovascular, First Affiliated Hospital of Medical College, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Di Fan
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Xiaowei Yao
- Department of Cardiovascular, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
| | - Gongchang Guan
- Department of Cardiovascular, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
| | - Junkui Wang
- Department of Cardiovascular, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
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Abd TT, George RT. Association of coronary plaque burden with fractional flow reserve: should we keep attempting to derive physiology from anatomy? Cardiovasc Diagn Ther 2015; 5:67-70. [PMID: 25774351 PMCID: PMC4329167 DOI: 10.3978/j.issn.2223-3652.2015.01.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 12/18/2014] [Indexed: 01/20/2023]
Abstract
Coronary computed tomography angiography (CTA) has been used increasingly for the diagnosis of coronary artery disease over the past decade. Compared to invasive coronary angiography (ICA), coronary CTA has the ability to visualize and quantify atherosclerotic plaque both calcified and non-calcified. Traditional measures of evaluating a coronary stenosis such as diameter stenosis, area stenosis, minimal lumen diameter and minimal luminal area are limited in their ability to predict its functional significance especially when diameter stenosis ranges between 30-69% (intermediate range). Measurement of invasive fractional flow reserve (FFR) is considered the gold standard for assessment of the hemodynamic significance of a stenosis. The current study by Nakazato et al. evaluates the performance of an emerging coronary CTA-derived anatomical measure "percent aggregate plaque volume" to improve the detection of hemodynamic significant stenosis as compared with invasive FFR.
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Affiliation(s)
- Thura T Abd
- Division of Cardiology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Richard T George
- Division of Cardiology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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Stefano GT, Bezerra HG, Attizzani G, Chamié D, Mehanna E, Yamamoto H, Costa MA. Utilization of frequency domain optical coherence tomography and fractional flow reserve to assess intermediate coronary artery stenoses: conciliating anatomic and physiologic information. Int J Cardiovasc Imaging 2011; 27:299-308. [PMID: 21409535 PMCID: PMC3984934 DOI: 10.1007/s10554-011-9847-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Accepted: 02/19/2011] [Indexed: 02/07/2023]
Abstract
Fractional flow reserve (FFR) and intravascular imaging respectively provide hemodynamic and anatomical assessments of angiographic intermediate stenoses. Frequency domain optical coherence tomography (FD-OCT) is a promising high-resolution imaging modality, but its clinical use in determining severity of coronary disease has yet to be determined. There, we set out to determine the role of FD-OCT to complement FFR in the evaluation of intermediate coronary artery stenoses. FD-OCT was planned in 176 consecutive interventional procedures at our institution to delineate the proper use of FD-OCT in clinical practice. The decision to use other invasive assessments was at the discretion of the operator. This report describes an early series of the 14 patients who underwent FFR of 18 target stenoses in addition to FD-OCT. FD-OCT was successfully performed without complications in all cases. Fractional flow reserve was <0.80 in four patients, with minimal lumen areas and reference vessel diameters ranging from 1.03 to 3.47 mm(2) and 2.60 to 2.94 mm by FD-OCT, respectively. FD-OCT was important to rule out plaque rupture, erosion and thrombosis and to help guide decision to defer PCI in six patients with acute coronary syndrome and FFR > 0.80. FD-OCT was also valuable to guide PCI strategy in tandem lesions with an FFR < 0.80. This initial experience with FD-OCT suggests a potential complementary role of physiological and anatomical assessment to guide decision making in complex clinical scenarios. Future investigations are warranted to validate these findings and define the role of FD-OCT in assessing intermediate lesions.
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Affiliation(s)
- Gregory T Stefano
- Harrington-McLaughlin Heart and Vascular Institute, Cardiovascular Imaging Core Laboratory, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH 44106-5038, USA
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