Zhang Shuyi, Wang Ming, Gan Qian, Zhai Xinrong, Chen Yang, Guan Shaofeng, Xu Xinxin, Wen Jiasheng, Qu Xinkai, Han Wenzheng
Department of Cardiology, Huadong Hospital Affiliated to Fudan University, 200040 Shanghai, China.
Department of Cardiology, Kunshan Hospital of Traditional Chinese Medicine, 215300 Kunshan, Jiangsu, China.
Rev Cardiovasc Med. 2024 Sep 18;25(9):329. doi: 10.31083/j.rcm2509329. eCollection 2024 Sep.
A fractional flow reserve (FFR)-fixed-SYNTAX score could decrease the number of high-risk patients. This study explored the prognostic value of non-invasive quantitative flow ratio (QFR)-fixed-SYNTAX I/II scores in multivessel disease patients.
This was a single-center, small-sample, observational study. Multivessel coronary disease patients were enrolled and finished a 1-year follow-up. SYNTAX scores I/II and functional SYNTAX scores I/II based on QFR (cut-off value of 0.85) were calculated for all patients. The composite occurrence of cardiac deaths, any myocardial infarction, or ischemia-driven revascularization were analyzed using a different score system.
A total of 160 patients were stratified into risk groups based on a different scoring system. FSS (functional SYNTAX score) and FSSII (functional SYNTAX score II) reduce the radio of high-risk major adverse cardiovascular events (MACEs), transforming the patients from high-risk to medium- and low-risk. Furthermore, FSSII (hazard ratio (HR): 1.069, 95% CI: 1.025-1.115, 0.002) showed a better relationship with MACEs than the other score systems. After recalculating SSII, the survival-free ratio stratified by FSSII decreased from 38.46% to 27.27% in the high-risk group and increased from 84.09% to 86.05% in the low-risk group.
FSS or FSSII could decrease the number of high-risk patients compared to SYNTAX score (SS) and FSS. SYNTAX II score (SSII) and FSSII showed a better predictive ability than other scoring systems for under-risk stratification.
分数流储备(FFR)固定的SYNTAX评分可减少高风险患者数量。本研究探讨了无创定量血流比(QFR)固定的SYNTAX I/II评分在多支血管病变患者中的预后价值。
这是一项单中心、小样本的观察性研究。纳入多支冠状动脉疾病患者并完成1年随访。为所有患者计算SYNTAX I/II评分以及基于QFR(临界值为0.85)的功能性SYNTAX I/II评分。使用不同的评分系统分析心源性死亡、任何心肌梗死或缺血驱动的血运重建的复合发生情况。
共160例患者根据不同评分系统分层为风险组。FSS(功能性SYNTAX评分)和FSSII(功能性SYNTAX评分II)降低了高危主要不良心血管事件(MACE)的发生率,将患者从高危转变为中低危。此外,FSSII(风险比(HR):1.069,95%置信区间:1.025 - 1.115,P = 0.002)与MACE的关系比其他评分系统更好。重新计算SSII后,高危组中按FSSII分层的无生存比例从38.46%降至27.27%,低危组从84.09%升至86.05%。
与SYNTAX评分(SS)和FSS相比,FSS或FSSII可减少高危患者数量。SYNTAX II评分(SSII)和FSSII在低危分层方面比其他评分系统具有更好的预测能力。