JACC:瞬时无波比 vs 流量储备分数指导下的急/慢性冠脉综合征患者血运重建的5年预后

2022-03-14 Nebula MedSci原创

根据iFR指导慢性或急性冠脉综合征患者进行血运重建的长期预后与FFR指导血运重建的预后无明显差异。

瞬时无波比 (瞬时无波比,iFR) 是一种冠状动脉生理指标,用于评估冠状动脉狭窄的严重程度,指导血运重建。流量储备分数 (FFR) 是第一个被广泛引入临床实践的指导血运重建的方法。FFR定义为充血时狭窄远端压力与狭窄近端压力的比值。iFR已被证明对短期预后的预测意义不劣于FFR,但关于长期预后的数据仍很匮乏。

本研究目的是对iFR-SWEDEHEART试验中根据iFR或FFR指导进行血运重建的慢性和急性冠状动脉综合征患者的主要复合结局 (全因死亡率、心肌梗死和非计划血运重建) 进行5年随访。

研究流程

iFR-SWEDEHEART试验是一项多中心、随机对照的、开放标签的临床使用,通过Swedish Coronary Angiography和Angioplasty Registry招募了2037位慢性或急性冠脉综合征患者。受试患者随机接受iFR(n=1019)或FFR(n=1018)评估后进行血运重建。主要终点是主要不良心脏事件(包括全因死亡、非致命性心肌梗死或非计划的血运重建)。

两组患者的复合终点的累积发生率

没有患者失访。第5年时,iFR组和FFR组的主要复合终点的发生率分别是21.5%和19.9%(风险比[HR] 1.09)。两组的全因死亡(9.4% vs 7.9%;HR 1.20)、非致命性心肌梗死(5.7% vs 5.8%;HR 1.00)和非计划的血运重建(11.6% vs 11.3%;HR 1.02) 的发生率也无明显差异。在预定的亚组分析中,结果一致。

该研究结果表明,慢性或急性冠脉综合征患者,根据iFR评估结果指导进行血运重建的长期预后(死亡、心肌梗死和非计划的血运重建的5年复合终点)与FFR指导血运重建的预后无明显差异

 

原始出处:

Gotberg Matthias,Berntorp Karolina,Rylance Rebecca et al. 5-Year Outcomes of PCI Guided by Measurement of Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve.[J] .J Am Coll Cardiol, 2022, 79: 965-974.

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    2022-11-10 hbwxf
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