Zhu Yunhui, Hu Tianli, Bian Qianqian, Chen Yufei, Zhou Tianping, Li Jing, Fu Guosheng, Zhang Wenbin, Hong Xulin
Department of Cardiology, Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, Hangzhou, 310016, Zhejiang Province, People's Republic of China.
Department of Cardiology, The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, 322000, People's Republic of China.
Sci Rep. 2025 Jul 1;15(1):21479. doi: 10.1038/s41598-025-05578-w.
Drug-Coated Balloons (DCB) have been widely used in interventional treatment for coronary artery de novo lesions. However, DCB treatment still have a certain proportion of target vessel restenosis (TLR) and adverse follow-up events. Quantitative flow ratio (QFR) loss are important indicators for evaluating long-term vascular functional changes. However, in patients with de novo lesions treated by DCB, the potential risk and protective factors affecting QFR loss remain unclear. The aim of this study was to explore the factors affecting QFR loss in patients with de novo lesion after DCB-angioplasty. Patients who underwent DCB-only intervention de novo lesions and underwent coronary angiography within 12 ± 3 months were enrolled. The QFR loss was defined as difference between the immediate post-procedure QFR and follow-up QFR. The subjects were divided into high QFR loss and low QFR loss groups according to the binary method. The predictors of QFR loss were then analyzed. A total of 115 patients with 1-year follow-up were included in this study, and the median follow-up time was 357 days. Multivariate Logistic analysis showed that patients with diabetes mellitus (OR = 4.937, 95%CI 1.497-16.278, P = 0.009) and LDL-C > 1.8 mmol/L (OR = 2.575, 95%CI 1.021-6.493, P = 0.045) was significantly associated with higher QFR loss 1 year after surgery. In patients undergoing DCB treatment for coronary de novo lesions, diabetes is an independent risk factor for late QFR loss at 1 year. Conversely, achieving LDL-C targets during follow-up is an independent protective factor against late QFR loss at 1 year.
药物涂层球囊（DCB）已广泛应用于冠状动脉初发病变的介入治疗。然而，DCB治疗仍有一定比例的靶血管再狭窄（TLR）和不良随访事件。定量血流比（QFR）损失是评估长期血管功能变化的重要指标。然而，在接受DCB治疗的初发病变患者中，影响QFR损失的潜在风险和保护因素仍不清楚。本研究的目的是探讨DCB血管成形术后初发病变患者QFR损失的影响因素。纳入仅接受DCB干预治疗初发病变且在12±3个月内行冠状动脉造影的患者。QFR损失定义为术后即刻QFR与随访QFR之间的差值。根据二分法将受试者分为高QFR损失组和低QFR损失组。然后分析QFR损失的预测因素。本研究共纳入115例进行1年随访的患者，中位随访时间为357天。多因素Logistic分析显示，糖尿病患者（OR = 4.937，95%CI 1.497 - 16.278，P = 0.009）和低密度脂蛋白胆固醇（LDL-C）>1.8 mmol/L（OR = 2.575，95%CI 1.021 - 6.493，P = 0.045）与术后1年较高的QFR损失显著相关。在接受DCB治疗冠状动脉初发病变的患者中，糖尿病是术后1年晚期QFR损失的独立危险因素。相反，随访期间达到LDL-C目标是术后1年晚期QFR损失的独立保护因素。
