Affiliation:
1. SHUPYK NATIONAL HEALTHCARE UNIVERSITY OF UKRAINE, KYIV, UKRAINE; HEART INSTITUTE OF THE MINISTRY OF HEALTH OF UKRAINE, KYIV, UKRAINE
2. STATE INSTITUTION OF SCIENCE «RESEARCH AND PRACTICAL CENTER OF PREVENTIVE AND CLINICAL MEDICINE» STATE ADMINISTRATIVE DEPARTMENT, KYIV, UKRAINE
3. HEART INSTITUTE OF THE MINISTRY OF HEALTH OF UKRAINE, KYIV, UKRAINE
Abstract
The aim: To identify clinical and angiographic factors, associated with fractional flow reserve (FFR), in stable coronary artery disease (CAD) patients.
Materials and methods: The study consecutively enrolled 68 patients with stable CAD (mean age (63±8,0) ys) and angiographically intermediate coronary lesions (diameter stenosis 50-90 %), with FFR assessment. Stable angina of CCS classes II and III was diagnosed in 42 (62 %) and 15 (22 %) patients, respectively; left ventricular hypertrophy (LVH) – 27 (40 %); severe coronary stenosis (SCS) (70-90 %) – 46 (68 %). The overall CAD complexity was assessed by SYNTAX score. FFR «negative» group (FFRNEG) included the patients with non-significant FFRs (>0,80) (n=28 [41 %]). In case of at least one significant FFR (≤0,80), a patient was assigned to FFR «positive» group (FFRPOS) (n=40 [59 %]).
Results: FFRPOS (vs. FFRNEG, respectively) was characterized by the higher frequency of angina class III (32 % vs. 7 %; p<0,001), LVH (53 % vs. 21 %; p=0,010) and SCS (98 % vs. 25 %; p<0,001). The SYNTAX score was strongly associated with FFR ≤0,70 and ≤0,65, and moderately – with FFR ≤0,65.
Conclusions: In patients with stable CAD and intermediate coronary artery stenosis, the presence of at least one functionally significant lesion (FFR ≤0,80) was associated with the higher prevalence of angina class III, LVH and more advanced coronary stenosis (≥70 %). The greater overall CAD complexity increased the probability for the angiographically significant coronary lesions to be more functionally compromised.