Differential Impact of Coronary Revascularization on Long-Term Clinical Outcome According to Coronary Flow Characteristics: Analysis of the International ILIAS Registry-Reference-Cited by-同舟云学术

Differential Impact of Coronary Revascularization on Long-Term Clinical Outcome According to Coronary Flow Characteristics: Analysis of the International ILIAS Registry

Published:2022-06 Issue:6 Volume:15 Page:
ISSN:1941-7640
Container-title:Circulation: Cardiovascular Interventions
language:en
Short-container-title:Circ: Cardiovascular Interventions

Author:

Hamaya Rikuta¹²^ORCID,van de Hoef Tim P.³⁴⁵,Lee Joo Myung⁶^ORCID,Hoshino Masahiro⁷,Kanaji Yoshihisa⁷^ORCID,Murai Tadashi⁸^ORCID,Boerhout Coen K.M.³^ORCID,de Waard Guus A.⁵,Jung Ji-Hyun⁹,Lee Seung Hun¹⁰^ORCID,Mejia Renteria Hernan¹¹,Echavarria-Pinto Mauro¹²,Meuwissen Martijn¹,Matsuo Hitoshi¹³^ORCID,Madera-Cambero Maribel¹⁴,Eftekhari Ashkan¹⁵,Effat Mohamed A.¹⁶,Marques Koen⁴,Doh Joon-Hyung¹⁷,Christiansen Evald H.¹⁵,Banerjee Rupak¹⁸¹⁹^ORCID,Nam Chang-Wook²⁰^ORCID,Niccoli Giampaolo²¹,Nakayama Masafumi¹³²²^ORCID,Tanaka Nobuhiro²³^ORCID,Shin Eun-Seok²⁴^ORCID,Sasano Tetsuo²⁵^ORCID,Chamuleau Steven A.J.³⁴,Knaapen Paul⁴,Escaned Javier¹¹^ORCID,Koo Bon Kwon²⁶^ORCID,Piek Jan J.³^ORCID,Kakuta Tsunekazu⁷^ORCID

Affiliation:

1. Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA (R.H.).

2. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (R.H.).

3. Department of Cardiology, Amsterdam UMC – location AMC, the Netherlands (T.P.v.d.H., C.K.M.B., S.A.J.C., J.J.P.).

4. Department of Cardiology, Amsterdam UMC – location VUmc, Amsterdam, the Netherlands (T.P.v.d.H., K.M., S.A.J.C., P.K.).

5. Department of Cardiology, NoordWest Ziekenhuisgroep, the Netherlands (T.P.v.d.H., G.A.d.W.).

6. Samsung Medical Center, Sungkyunkwan University School of Medicine, Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Seoul, Republic of Korea (J.M.L.).

7. Department of Cardiology, Tsuchiura Kyodo General Hospital, Japan (M.H., Y.K., T.K.).

8. Cardiovascular Center, Yokosuka Kyosai Hospital, Japan (T.M.).

9. Sejong General Hospital, Sejong Heart Institute, Bucheon, Korea (J.-H.J.).

10. Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea (S.H.L.).

11. Hospital Clínico San Carlos, IDISSC, and Universidad Complutense de Madrid, Spain (H.M.R., J.E.).

12. Hospital General ISSSTE Querétaro - Facultad de Medicina, Universidad Autónoma de Querétaro, México (M.E.-P.).

13. Department of Cardiovascular Medicine, Gifu Heart Center, Japan (H.M., M.N.).

14. Department of Cardiology, Tergooi Hospital, Blaricum, the Netherlands (M.M.-C.).

15. Department of Cardiology, Aarhus University Hospital, Denmark (A.E., E.H.C.).

16. Division of Cardiovascular Health and Diseases, Department of Internal Medicine (M.A.E.), University of Cincinnati, OH.

17. Department of Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea (J.-H.D.).

18. Mechanical and Materials Engineering Department (R.B.), University of Cincinnati, OH.

19. Research Services, Veteran Affairs Medical Center, Cincinnati, OH (R.B.).

20. Department of Medicine, Inje University Ilsan Paik Hospital, Goyang, South Korea (C.-W.N.).

21. Catholic University of the Sacred Heart, Department of Cardiovascular Medicine, Institute of Cardiology, Rome, Italy (G.N.).

22. Toda Central General Hospital, Cardiovascular Center, Japan (M.N.).

23. Department of Cardiology, Tokyo Medical University Hachioji Medical Center, Japan (N.T.).

24. Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, South Korea (E.-S.S.).

25. Department of Cardiology, Tokyo Medical and Dental University, Japan (T.S.).

26. Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, Republic of Korea (B.K.K.).

Abstract

Background: Coronary pressure indices such as fractional flow reserve are the standard for guiding elective revascularization. However, considering additional coronary flow parameters could further individualize and optimize the decision on revascularization. We aimed to investigate the potentially differential prognostic associations of elective percutaneous coronary intervention (PCI) according to coronary flow properties represented by coronary flow reserve (CFR), coronary flow capacity (CFC), and baseline CFC (bCFC). Methods: From the ILIAS Registry (Inclusive Invasive Physiological Assessment in Angina Syndromes) composed of 16 hospitals globally from 7 countries, patients with obstructive coronary artery disease who underwent invasive coronary physiological assessment were included (N=2370 vessels). We assessed effect measure modifications of the association of PCI and 5-year target vessel failure according to CFR, CFC, and bCFC either assessed by Doppler-technique or thermodilution-method. Results: The mean age of the population was 63.3 years, and there were 1322 (73.6%) males. Median fractional flow reserve was 0.85, and PCI was performed in 600 (25.3%) vessels. Reduced CFR, CFC, and abnormal bCFC were defined in 988 (41.7%), 542 (22.9%), and 600 (25.3%) vessels, respectively. Significant effect measure modifications were observed by CFC either in odds ratio ( P =0.0018), additive ( P =0.029), and hazard ratio scale ( P =0.0002). The absolute risk of 5-year target-vessel failure was higher if treated by PCI in vessels with normal CFC by 1.8 (−1.7 to 5.3) percent, while that was lower by −5.9 (−12 to −0.1) percent in those with reduced CFC. CFR and bCFC were not significant effect modifiers in any scales. Similar associations were observed in per-patient analyses, whereas the findings were less robust. Conclusions: We observed qualitative effect measure modification of PCI and 5-year clinical outcomes according to CFC status in additive scale. CFR and bCFC were not robust effect modifiers. Therefore, CFC could be potentially used to optimize the patient selection for elective PCI treatment combined with fractional flow reserve.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

Reference27 articles.

1. A Randomized Trial of Therapies for Type 2 Diabetes and Coronary Artery Disease

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