ステントを挿入した後の冠動脈圧測定は,フォローアップ時に有害事象を予測する:多センター登録
Nico H J Pijls1, Volker Klauss, Uwe Siebert
1Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands. cardiologie.catharina.zks@wxs.nl
Circulation
|June 26, 2002
まとめ
冠動脈ステントを設置した後の断片流量準備 (FFR) は,患者のアウトカムを予測します. ステント移植後の最適なFFRを達成すると,主要な有害事象が著しく減少し,心臓血管ケアにおけるその重要性を強調します.
科学分野:
- 心臓病学 心臓病学
- 介入性心臓病学 介入性心臓病学
- 医療機器 医療機器について
背景:
- 冠動脈ステントは,最適の血管造形インプランテーションにもかかわらず,6ヶ月で15-20%のレステノス率を持っています.
- ステント移植後の生理学的評価は,患者の治療結果を改善する可能性があります.
研究 の 目的:
- ステント後断片流量準備 (FFR) と6ヶ月の臨床結果との関係を調査する.
- 生理学的ステントの植え付けが,血管学的評価のみと比較して患者の結果を改善するかどうかを判断する.
主な方法:
- 冠動脈ステントを挿入する750人の患者のマルチセンター登録です.
- 冠動脈圧の測定は,ステント設置後の最大高血圧時に行われました.
- ステント置換後のFFRを計算し,6ヶ月後の主要な有害事象と相関させました.
主要な成果:
- 10.2%の患者が主要な有害事象 (死亡,心筋梗塞,再血管化) を経験した.
- ステント後のFFRは,有害事象の最も強い独立した予測因子 (P<0.001) でした.
- FFR>0.95では4.9%,FFR>0.95では6.2%,FFR>0.90~0.95,FFR>0.90では20.3%,FFR>0.80では29.5%であった.
結論:
- ステントを挿入した後の断片流量準備 (FFR) は,6ヶ月のアウトカムの決定的な独立した予測因子です.
- ステント移植後のFFRの最適化は,不良心血管疾患の減少に不可欠です.
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