JA Toride Medical Center, Ibaraki, Japan.
Tokyo Medical and Dental University, Tokyo, Japan.
Catheter Cardiovasc Interv. 2020 Mar 1;95(4):E100-E107. doi: 10.1002/ccd.28345. Epub 2019 May 29.
The aim of this study was to investigate the impact of intensively lowered low-density lipoprotein cholesterol (LDL-C) level on the deferred lesion prognosis after revascularization deferral based on fractional flow reserve (FFR).
Lowering LDL-C is associated with lower cardiovascular event rate, but its benefit on the deferred lesion prognosis has not been well evaluated.
This retrospective, single-center, observational study analyzed 192 deferred lesions with FFR value >0.80 in 192 patients with stable coronary artery disease. According to the first follow-up LDL-C level, they were assigned to the LOW group (<70 mg/dL) or the HIGH group (≥70 mg/dL). Deferred lesion failure (DLF) was defined as the composite of deferred lesion revascularization and deferred vessel myocardial infarction.
Of all participants, 61 and 131 patients were assigned to the LOW and the HIGH group, respectively. During the median follow-up of 2.8 years, DLF occurred in 1 and 14 patients in the LOW group and the HIGH group (1.6% and 10.7%, log-rank p = .043), respectively. The incidence of any unplanned revascularization was also significantly lower in the LOW group than in the HIGH group (3.3% vs. 14.5%, log-rank p = .032).
The incidence of DLF was significantly lower in the patients with LDL-C < 70 mg/dL than in those with LDL-C ≥ 70 mg/dL at the first follow-up after FFR-based deferral of revascularization.
本研究旨在探讨基于血流储备分数（FFR）的血运重建延迟后，强化降低低密度脂蛋白胆固醇（LDL-C）水平对延迟病变预后的影响。
降低 LDL-C 与心血管事件发生率降低相关，但它对延迟病变预后的益处尚未得到很好的评估。
这是一项回顾性、单中心、观察性研究，共纳入 192 例稳定性冠心病患者的 192 处 FFR 值>0.80 的延迟病变。根据首次随访时的 LDL-C 水平，患者被分为 LOW 组（<70mg/dL）或 HIGH 组（≥70mg/dL）。延迟病变失败（DLF）定义为延迟病变血运重建和延迟血管心肌梗死的复合终点。
所有患者中，LOW 组和 HIGH 组分别有 61 例和 131 例。在中位 2.8 年的随访期间，LOW 组和 HIGH 组分别有 1 例和 14 例患者发生 DLF（1.6%和 10.7%，log-rank p=0.043）。LOW 组的任何计划性血运重建发生率也显著低于 HIGH 组（3.3% vs. 14.5%，log-rank p=0.032）。
在基于 FFR 的血运重建延迟后首次随访时 LDL-C<70mg/dL 的患者，其 DLF 发生率显著低于 LDL-C≥70mg/dL 的患者。
