在焦点和扩散冠状动脉疾病中,分量流量储备引导式支架的优化
Hirofumi Ohashi1,2, Damien Collison3,4, Takuya Mizukami1,5,6
1Cardiovascular Center Aalst, OLV Clinic, 9300 Aalst, Belgium.
Diagnostics (Basel, Switzerland)
|August 12, 2023
概括
生理学引导的增量优化策略 (PIOS) 更常用于扩散性冠状动脉疾病 (CAD). 然而,当使用PIOS时,焦点CAD患者在支架后获得了更好的结果.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗器械 医疗器械
背景情况:
- 穿皮冠状动脉干预 (PCI) 支架需要生理评估以获得最佳结果.
- 冠状动脉疾病 (CAD) 模式,焦点与扩散,影响PCI的成功.
- CAD模式对生理学引导的支架优化的影响尚不清楚.
研究的目的:
- 研究焦点与扩散CAD对生理指导增量优化策略 (PIOS) 的结果的影响.
- 评估回拉压梯度 (PPG) 指数在描述CAD模式中的有用性.
- 根据CAD模式,在PIOS治疗的患者中比较后支架分流储备 (FFR).
主要方法:
- 对TARGET-FFR试验 (NCT03259815) 的一项子研究包括了114名PCI前后FFR退出患者.
- 焦点CAD被定义为一个PPG≥0.74.
- 如果PCI后FFR为<0.90.0,PIOS手臂中的患者经历了优化.
主要成果:
- PPG与PCI后的FFR和正常化的三角形FFR有显著的相关性.
- 与焦点CAD (6%) 相比,在扩散CAD (42%) 中使用PIOS的频率更高.
- 在PIOS手臂中,焦点CAD患者在PCI后获得的FFR比扩散CAD患者 (0.83 ± 0.07) 高 (0.93 ± 0.05).
- 在PCI后FFR的CAD模式和随机化臂之间发现了显著的相互作用 (p=0.004).
结论:
- 生理学引导的支架优化更频繁地应用于扩散CAD.
- 当使用PIOS时,焦点CAD患者在PCI后获得了优异的FFR,与使用PIOS时扩散CAD患者相比.
- CAD模式显著影响生理学引导的支架优化策略的有效性.
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