Chen Huaigang, Hong Lang, Xi Gang, Wang Hong, Hu Jing, Liu Qi, Yang Liu
Medical College of Nanchang University, Nanchang, China.
Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China.
Front Cardiovasc Med. 2023 Aug 7;10:1164290. doi: 10.3389/fcvm.2023.1164290. eCollection 2023.
Coronary atherosclerotic heart disease is one of the most serious health and life-threatening diseases. There is no doubt that despite the increasing number of assessment methods used clinically, the prognosis assessment is still not ideal, and newer assessment methods are needed.
To investigate the predictive value of quantitative flow ratio (QFR) for adverse events (vessel-oriented composite endpoint events/target lesion failure) in patients after percutaneous coronary intervention (PCI).
Eight studies involving 4,173 patients (5,688 vascular lesions) were included. These are studies on the relationship between QFR values and prognosis of adverse cardiac events after PCI. This meta-analysis was performed after quality assessment and data extraction of clinical trials data that met the inclusion criteria.
Each of the eight studies described the cut-off values for the best predictive ability of post-PCI QFR and the hazard ratio (HR) between QFR values and adverse events, respectively. The pooled HR of these studies was 4.72 (95% CI: 3.29-6.75). Concurrently, lower post-PCI QFR values were associated with the occurrence of individual clinical events (cardiac death/myocardial infarction/target vessel revascularization), with relative risk values of 6.51 (95% CI: 4.96-8.53), 4.83 (95% CI: 3.08-7.57), and 4.21 (95% CI: 2.66-6.68), respectively.
QFR may have great potential in the assessment of prognosis. It is necessary to measure QFR value after PCI. A lower QFR value after PCI was an important predictor for experiencing adverse events.
冠状动脉粥样硬化性心脏病是最严重的健康和危及生命的疾病之一。毫无疑问,尽管临床上使用的评估方法数量不断增加,但预后评估仍然不理想,需要更新的评估方法。
探讨定量血流比(QFR)对经皮冠状动脉介入治疗(PCI)术后患者不良事件(血管定向复合终点事件/靶病变失败)的预测价值。
纳入八项研究,共4173例患者(5688个血管病变)。这些研究是关于QFR值与PCI术后不良心脏事件预后的关系。本荟萃分析是在对符合纳入标准的临床试验数据进行质量评估和数据提取后进行的。
八项研究分别描述了PCI术后QFR最佳预测能力的截断值以及QFR值与不良事件之间的风险比(HR)。这些研究的合并HR为4.72(95%CI:3.29-6.75)。同时,PCI术后较低的QFR值与个体临床事件(心源性死亡/心肌梗死/靶血管血运重建)的发生相关,相对风险值分别为6.51(95%CI:4.96-8.53)、4.83(95%CI:3.08-7.57)和4.21(95%CI:2.66-6.68)。
QFR在预后评估中可能具有很大潜力。PCI术后测量QFR值很有必要。PCI术后较低的QFR值是发生不良事件的重要预测指标。