Zhang Liying, Xie Dingxiong, Gan Yirong, Zhang Zheng, Wang Yanzhen, Xie Jing, Zhang Bo, Kou Zongke, Zhang Yunlong, Li Bing, Kou Xiaoqing, Mao Rui, Jin Jianjian, Liang Tianxiang, Li Sheng
Gansu Institute of Cardiovascular Diseases, Lanzhou, China.
Department of Cardiovascular Medicine, The First Hospital of Lanzhou University, Lanzhou, China.
Medicine (Baltimore). 2024 Dec 13;103(50):e40644. doi: 10.1097/MD.0000000000040644.
This study investigated the clinical value of coronary arteriography (CAG) combined with fractional flow reserve (FFR) in the treatment of coronary heart disease (CHD) with coronary artery stenosis exceeding 70%. A retrospective analysis was conducted on 344 patients with CHD treated at the Gansu Institute of Cardiovascular Science from January 2020 to May 2022. The patients were divided into the CAG group (n = 138) and the CAG + FFR group (n = 206). Among these patients, those with coronary artery stenosis exceeding 70% underwent an FFR functional examination to accurately determine indicators for coronary intervention. The data collected included demographic information, number of stents, number of vascular lesions, treatment methods, and the occurrence of major adverse cardiovascular events (MACE) at the 6-month follow-up. No significant differences were found between the 2 groups in terms of age, gender, underlying diseases, body mass index (BMI), smoking history, and blood lipid profile. The rate of surgical treatment in the CAG group and the CAG + FFR group was 88.41% and 43.69%, respectively. The CAG + FFR group showed a 44.72% reduction in the need for surgical treatment and a reduced number of stents placed, which helped prevent overtreatment. Additionally, there was no statistical difference between the 2 groups in MACE such as angina pectoris, myocardial infarction, and sudden cardiac death at the 6-month follow-up. After combined CAG examination with FFR measurement, the number of CHD patients with coronary artery stenosis exceeding 70% requiring surgical intervention decreased by 44.72%. FFR could significantly prevent overtreatment and provide more precise guidance for CHD treatments.
本研究探讨冠状动脉造影(CAG)联合血流储备分数(FFR)在治疗冠状动脉狭窄超过70%的冠心病(CHD)中的临床价值。对2020年1月至2022年5月在甘肃省心血管病研究所接受治疗的344例冠心病患者进行回顾性分析。患者分为CAG组(n = 138)和CAG + FFR组(n = 206)。在这些患者中,冠状动脉狭窄超过70%的患者接受FFR功能检查,以准确确定冠状动脉介入指标。收集的数据包括人口统计学信息、支架数量、血管病变数量、治疗方法以及6个月随访时主要不良心血管事件(MACE)的发生情况。两组在年龄、性别、基础疾病、体重指数(BMI)、吸烟史和血脂谱方面无显著差异。CAG组和CAG + FFR组的手术治疗率分别为88.41%和43.69%。CAG + FFR组手术治疗需求减少44.72%,置入支架数量减少,有助于避免过度治疗。此外,两组在6个月随访时的心绞痛、心肌梗死和心源性猝死等MACE方面无统计学差异。CAG检查联合FFR测量后,冠状动脉狭窄超过70%需要手术干预的冠心病患者数量减少了44.72%。FFR可显著避免过度治疗,并为冠心病治疗提供更精确的指导。