Department of Cardiology, Beijing an Zhen Hospital, Capital Medical University, and Beijing Institute of Heart, Lung, and Blood Vessel Disease, Beijing, China.
J Interv Cardiol. 2022 Oct 13;2022:9057832. doi: 10.1155/2022/9057832. eCollection 2022.
Intermediate coronary stenosis (ICS) is defined as a visually estimated percentage of diameter stenosis ranging between 40% and 70% by conventional coronary angiography (CAG). Whether to perform percutaneous coronary intervention (PCI) for these lesions is a challenge in clinical practice. The fractional flow reserve (FFR) can guide treatment by determining the functional significance of ICS. Studies have shown that some clinical indicators can be used to predict FFR. However, there is little research on this in the Chinese population.
We retrospectively analyzed 690 patients who underwent FFR measurements to determine the functional significance of a single ICS. Patients were divided into 2 groups: FFR ≤0.8 ( = 280) and FFR >0.8 ( = 410). We compared the clinical factors between the two groups and performed multivariate logistic regression analyses to explore the risk factors. In addition, receiver-operating characteristic (ROC) curves were constructed for FFR ≤0.8 diagnoses.
The mean UHR (uric acid to high-density lipoprotein cholesterol ratio) level was significantly higher in the FFR ≤0.8 group ( < 0.001). UHR corrects negatively with FFR ( = -0.44, < 0.001). High-level UHR was an independent risk factor for the FFR ≤0.8 (OR = 7.17, 95% CI 4.17-12.34). The area under the curve (AUC) of the UHR diagnostic capacity for the FFR ≤0.8 is 0.77, with 77.3% sensitivity and 68.2% specificity.
UHR levels were significantly increased in patients with hemodynamically significant coronary lesions. UHR is a novel predictor of functionally significant lesions in patients with a single-vessel disease of ICS.
中度冠状动脉狭窄（ICS）是指通过常规冠状动脉造影（CAG）目测直径狭窄程度在 40%到 70%之间。对于这些病变是否进行经皮冠状动脉介入治疗（PCI）是临床实践中的一个挑战。血流储备分数（FFR）可以通过确定 ICS 的功能意义来指导治疗。研究表明，可以使用一些临床指标来预测 FFR。然而，在中国人群中对此研究甚少。
我们回顾性分析了 690 例行 FFR 测量以确定单一 ICS 功能意义的患者。患者分为 2 组：FFR≤0.8（ = 280）和 FFR>0.8（ = 410）。我们比较了两组之间的临床因素，并进行了多变量逻辑回归分析以探讨危险因素。此外，还构建了 FFR≤0.8 诊断的接收者操作特征（ROC）曲线。
FFR≤0.8 组的平均 UHR（尿酸与高密度脂蛋白胆固醇比值）水平明显较高（<0.001）。UHR 与 FFR 呈负相关（ = -0.44，<0.001）。高水平的 UHR 是 FFR≤0.8 的独立危险因素（OR = 7.17，95%CI 4.17-12.34）。UHR 对 FFR≤0.8 的诊断能力的曲线下面积（AUC）为 0.77，灵敏度为 77.3%，特异性为 68.2%。
血流动力学意义重大的冠状动脉病变患者的 UHR 水平显著升高。UHR 是单支血管 ICS 患者功能性病变的新预测指标。
