계명대학교 의학도서관 Repository

Long-term Patient Prognostication by Coronary Flow Reserve and Index of Microcirculatory Resistance: International Registry of Comprehensive Physiologic Assessment

Metadata Downloads
Author(s)
Joo Myung LeeKi Hong ChoiJoon-Hyung DohChang-Wook NamEun-Seok ShinMasahiro HoshinoTadashi MuraiTaishi YonetsuHernán Mejía-RenteríaTsunekazu KakutaJavier EscanedBon-Kwon Koo
Keimyung Author(s)
Nam, Chang Wook
Department
Dept. of Internal Medicine (내과학)
Journal Title
Korean Circulation Journal
Issued Date
2020
Volume
50
Issue
10
Keyword
Myocardial ischemiaCoronary artery diseaseFractional flow reserveCoronary flow reserveIndex of microcirculatory resistancePercutaneous coronary intervention
Abstract
Background and Objectives:
Recent guideline recommends evaluation using of coronary flow reserve (CFR) and index of microcirculatory resistance (IMR) in patients with functionally insignificant stenosis. We evaluated clinical implications of CFR and IMR in patients with high fractional flow reserve (FFR) and deferred revascularization.

Methods:
A total of 867 patients (1,152 vessels) consigned to deferred revascularization who underwent comprehensive physiologic assessments were enrolled. Patients with high FFR (>0.80) were categorized by CFR (≤2) and IMR (≥23 U). Clinical outcome was assessed by patient-oriented composite outcome (POCO), a composite of any death, myocardial infarction (MI), and revascularization at 5 years.

Results:
Patients with low CFR (≤2) showed significantly greater risk of POCO than those with high CFR (>2) in both high-FFR (p=0.024) and low-FFR (p=0.034) groups. In patients with high FFR, those with low CFR and high IMR (overt microvascular disease) displayed the greatest risk of POCO overall (p=0.015), surpassing those with high CFR and low IMR (HR, 2.873; 95% CI, 1.476–5.594; p=0.002) and showing significantly greater risk of cardiac death or MI (HR, 5.662; 95% CI, 1.984–16.154; p=0.001). Overt microvascular disease was independently associated with POCO in the high-FFR population (HR, 2.282; 95% CI, 1.176–4.429; p=0.015).

Conclusion:
Among patients with deferred revascularization, those with low CFR showed significantly greater risk of POCO than those with high CFR, regardless of FFR. In patients with high FFR, those with overt microvascular disease showed significantly greater risk of POCO and cardiac death or MI at 5-year, compared with the others.
Keimyung Author(s)(Kor)
남창욱
Publisher
School of Medicine (의과대학)
Citation
Joo Myung Lee et al. (2020). Long-term Patient Prognostication by Coronary Flow Reserve and Index of Microcirculatory Resistance: International Registry of Comprehensive Physiologic Assessment. Korean Circulation Journal, 50(10), 890–903. doi: 10.4070/kcj.2020.0083
Type
Article
ISSN
1738-5555
Source
https://www.e-kcj.org/search.php?where=aview&id=10.4070/kcj.2020.0083&code=0054KCJ&vmode=FULL
DOI
10.4070/kcj.2020.0083
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/42873
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
공개 및 라이선스
  • 공개 구분공개
파일 목록

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