| Autor: |
Katerina Sokolova, Dobrin Vassilev, Gianluca Rigatelli, Ghassan S. Kassab, Jeroen Sonck, Robert J. Gil, Vladimir Naunov, Kiril Karamfiloff, Niya Mileva, Pavel Nikolov, Carlos Collet |
| Rok vydání: |
2021 |
| Předmět: |
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| DOI: |
10.21203/rs.3.rs-702610/v1 |
| Popis: |
Background: Considerable progress has been made in the treatment of coronary bifurcation stenosis. Anatomical characteristics of the vessel and lesion, however, fail to give information about the functional significance of the bifurcation stenosis. To the best of our knowledge, there is no study that systematically establishes the baseline functional significance of coronary stenosis and its effect on procedural and clinical outcomes.Methods: Patients with significant angiographic bifurcation lesions defined as diameter stenosis > 50% in main vessel and/or side branch were included. FFR was performed in main vessel (MV) and side branch (SB) before and after percutaneous coronary intervention (PCI). 169 patients from Fiesta study (derivation cohort) and 555 patients from prospective bifurcation registry (test cohort) were analyzed to validate angiographic prediction score (BFSS) used to determine the potentially functional significance of coronary bifurcation stenosis.Results: Bifurcation functional significance score (including the following parameters - SYNTAX ≥11, SB/MB BARI score, MV %DS ≥ 55%, MB %DS ≥ 65%, lesion length ≥25mm) with a maximum value of 11 was developed. A cut-off value of 8.5 was shown to give the best discriminatory ability – with accuracy 87% (sensitivity 77%, specificity 96%, pConclusion: An angiographic score (BFSS) with good discriminatory ability to determine the functional significance of coronary bifurcation stenosis was developed. The value for BFSS≥8.5 can be used as a discriminator to define groups with higher risk for all-cause and cardiac mortality. Also, we found that the smaller side branches pose greater mortality risk. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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