계명대학교 의학도서관 Repository

Prognostic Implication of Thermodilution Coronary Flow Reserve in Patients Undergoing Fractional Flow Reserve Measurement

Metadata Downloads
Author(s)
Joo Myung LeeKi Hong ChoiDoyeon HwangJonghanne ParkJi-Hyun JungHyung Yoon KimHae Won JungYun-Kyeong ChoHyuck-Jun YoonYoung Bin SongJoo-Yong HahnJoon-Hyung DohChang-Wook NamEun-Seok ShinSeung-Ho HurBon-Kwon Koo
Keimyung Author(s)
Cho, Yun KyeongYoon, Hyuck JunNam, Chang WookHur, Seung Ho
Department
Dept. of Internal Medicine (내과학)
Journal Title
JACC: Cardiovascular Interventions
Issued Date
2018
Volume
11
Issue
15
Abstract
OBJECTIVES
This study investigated the prognostic implication of coronary flow reserve (CFR) in patients who underwent fractional flow reserve (FFR) measurement.

BACKGROUND
Limited data are available regarding the long-term prognosis associated with thermodilution CFR in patients with coronary artery disease.

METHODS
A total of 519 patients (737 vessels) who did not undergo revascularization were classified according to FFR and CFR values. Low FFR and low CFR were defined with upper thresholds of 0.8 and 2.0, respectively. FFR and CFR were measured by a pressure-temperature sensor–tipped wire. Clinical outcomes were assessed by the vessel-oriented composite outcome (VOCO) (a composite of cardiac death, vessel-specific myocardial infarction, and vessel-specific revascularization) during 5 years of follow-up.

RESULTS
The categorical agreement (kappa ¼ 0.080; p ¼ 0.024) between FFR and CFR were modest, and 30.6% of the population showed discordant results between FFR and CFR. During 5 years of follow-up, patients with low CFR had a significantly higher risk of VOCO than did those with high CFR (hazard ratio [HR]: 3.171; 95% CI: 1.664 to 6.042; p < 0.001). Among patients with high FFR, there were no differences in clinical risk factor profiles, FFR, or stenosis severity between the high-CFR and low-CFR groups, and low CFR was an independent predictor for VOCO
(HR: 4.999; 95% CI: 2.104 to 11.879; p < 0.001). In a 4-group classification according to both FFR and CFR, patients with low FFR and low CFR had the highest risk of VOCO (17.9%; overall p < 0.001).

CONCLUSIONS
Patients with low CFR had a significantly higher risk of clinical events during 5 years of follow-up. Low CFR was an independent predictor for patient-oriented composite outcome among patients with high FFR. These results support the value of CFR in patients who undergo FFR measurement. (Clinical, Physical and Prognostic Implication of Microvascular Status; NCT02186093) (J Am Coll Cardiol Intv 2018;11:1423–33)
Keimyung Author(s)(Kor)
조윤경
윤혁준
남창욱
허승호
Publisher
School of Medicine (의과대학)
Citation
Joo Myung Lee et al. (2018). Prognostic Implication of Thermodilution Coronary Flow Reserve in Patients Undergoing Fractional Flow Reserve Measurement. JACC: Cardiovascular Interventions, 11(15), 1423–1433. doi: 10.1016/j.jcin.2018.05.005
Type
Article
ISSN
1876-7605
Source
https://www.sciencedirect.com/science/article/pii/S1936879818310434?via%3Dihub
DOI
10.1016/j.jcin.2018.05.005
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41754
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
공개 및 라이선스
  • 공개 구분공개
  • 엠바고Forever
파일 목록

Items in Repository are protected by copyright, with all rights reserved, unless otherwise indicated.