Prognostic value of quantitative flow ratio measured imme-diately after percutaneous coronary intervention for chronic to-tal occlusion
Zheng QIAO1
Zhang-Yu LIN1
Qian-Qian LIU2
Rui ZHANG1
Chang-Dong GUAN3
Sh-eng YUAN1
Tong-Qiang ZOU3
Xiao-Hui BIAN1
Li-Hua XIE3
Cheng-Gang ZHU1
Hao-Yu WANG1
Guo-Feng GAO1
Ke-Fei DOU4
1.State Key Laboratory of Cardiovascular Disease,Beijing,China;Cardiometabolic Medicine Center,National Clini-cal Research Center for Cardiovascular Diseases,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China2.Cardiometabolic Medicine Center,National Clini-cal Research Center for Cardiovascular Diseases,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China3.Department of Cardiology,Nation-al Clinical Research Center for Cardiovascular Diseases,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China4.State Key Laboratory of Cardiovascular Disease,Beijing,China;Cardiometabolic Medicine Center,National Clini-cal Research Center for Cardiovascular Diseases,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China;National Clinical Research Center for Cardiovascular Diseases,Fuwai Hospital Chinese Academy of Medical Sciences,Shenzhen,China
摘要：BACKGROUND The clinical impact of post-percutaneous coronary intervention(PCI)quantitative flow ratio(QFR)in patients treated with PCI for chronic total occlusion(CTO)was still undetermined.
METHODS All CTO vessels treated with successful anatomical PCI in patients from PANDA III trial were retrospectively measured for post-PCI QFR.The primary outcome was 2-year vessel-oriented composite endpoints(VOCEs,composite of target vessel-related cardiac death,target vessel-related myocardial infarction,and ischemia-driven target vessel revascularization).Receiver operator characteristic curve analysis was cond-ucted to identify optimal cutoff value of post-PCI QFR for predicting the 2-year VOCEs,and all vessels were stratified by this optimal cutoff value.Cox proportional hazards models were employed to calculate the hazard ratio(HR)with 95%CI.
RESULTS Among 428 CTO vessels treated with PCI,353 vessels(82.5%)were analyzable for post-PCI QFR.31 VOCEs(8.7%)occurred at 2 years.Mean value of post-PCI QFR was 0.92±0.13.Receiver operator characteristic curve analysis shown the optimal cutoff value of post-PCI QFR for predicting 2-year VOCEs was 0.91.The incidence of 2-year VOCEs in the vessel with post-PCI QFR<0.91(n=91)was significantly higher compared with the vessels with post-PCI QFR≥0.91(n=262)(22.0%vs.4.2%,HR=4.98,95%CI:2.32-10.70).
CONCLUSIONS Higher post-PCI QFR values were associated with improved prognosis in the PCI practice for coronary CTO.Achieving functionally optimal PCI results(post-PCI QFR value≥0.91)tends to get better prognosis for patients with CTO lesions.
机标关键词：percutaneousquantitativeafterflowchroniccoronaryimme-diatelyintervention
论文发表日期：2025-04-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：10( 433-442 )