在冠状动脉病患者进行门手术时,功能性不完整再血管化的预后价值
Fang Zhang1, Wei Gao2, Wenshuo Wang3
1School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China.
JACC. Asia
|August 29, 2025
概括
在冠状动脉疾病的门手术患者中使用定量流量比的功能评估显著预测了主要的心血管不良事件 (MACE). 功能性不完整的重血管化与较高的MACE相关,支持其用于指导治疗.
科学领域:
- 心血管医学
- 干预心脏病学
- 心脏外科
背景情况:
- 冠状动脉扫描是评估冠状动脉疾病的标准.
- 评估冠状动脉病变对于最佳患者结果至关重要.
研究的目的:
- 使用定量流量比 (QFR) 评估功能评估的预后价值.
- 在接受门手术的患者中比较功能与解剖学标准.
主要方法:
- 分析了一组750名经历了显著冠状动脉狭窄的患者 (50% - 90%).
- 根据功能 (QFR) 和解剖学标准,患者被分为完全重血管 (CR) 或不完全重血管 (ICR) 组.
- 主要心血管不良事件 (MACE) 的追踪时间为3. 0年的中位数.
主要成果:
- 功能性不完整复血管 (ICR) 与功能性完整复血管 (CR) (10. 9%) 相比,MACE (20. 5%) 的显著增加 (HR: 1.98;P< 0. 001).
- 在解剖学ICR和CR组之间没有观察到MACE率的显著差异 (16. 3%对12. 2%;P=0. 153).
- 功能性ICR是MACE的独立预测因子 (调整HR为1. 63;P=0. 038).
结论:
- 在接受门手术的冠状动脉疾病患者中,功能性不完整的再血管化与更高的MACE相关.
- 这些发现突显了功能评估 (QFR) 在指导重血管化决策以改善患者的结果的重要性.
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