Prognostic value of intracoronary flow velocity and diameter stenosis in assessing the short and long-term outcomes of coronary balloon angioplasty
| Autor: | Michael Haude, Gian Battista Danzi, Claude Hanet, P. W. Serruys, A.J. Ford jr, Håkan Emanuelsson, Eric Boersma, Erwin Schroeder, B. De Bruyne, H.O. Peels, H Geschwind, C. Di Mario, Vasilis Voudris, Eckart Fleck, Ch. Vrints, Peter Probst, Edoardo Verna, V. Muhlberger, Jan J. Piek |
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| Přispěvatelé: | Cardiology, Faculteit der Geneeskunde |
| Jazyk: | angličtina |
| Rok vydání: | 1997 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Coronary Disease Balloon Coronary Angiography Restenosis Predictive Value of Tests Recurrence Risk Factors Physiology (medical) Angioplasty Internal medicine Coronary Circulation Medicine Humans Myocardial infarction Postoperative Period Prospective Studies Angioplasty Balloon Coronary Prospective cohort study Aged Ultrasonography Stenosis business.industry Coronary flow reserve Middle Aged medicine.disease Prognosis Predictive value of tests Cardiology Female Radiology Cardiology and Cardiovascular Medicine business Rheology Blood Flow Velocity |
| Zdroj: | Circulation, 96, 3369-3377. Lippincott Williams & Wilkins Circulation, 96, 3369-3377. Lippincott Williams and Wilkins Ltd. Scopus-Elsevier |
| ISSN: | 0009-7322 |
| Popis: | Background The aim of this prospective, multicenter study was the identification of Doppler flow velocity measurements predictive of clinical outcome of patients undergoing single-vessel balloon angioplasty with no previous Q-wave myocardial infarction. Methods and Results In 297 patients, a Doppler guidewire was used to measure basal and maximal hyperemic flow velocities proximal and distal to the stenosis before and after angioplasty. In 225 patients with an angiographically successful percutaneous transluminal coronary angioplasty (PTCA), postprocedural distal coronary flow reserve (CFR) and percent diameter stenosis (DS%) were correlated with symptoms and/or ischemia at 1 and 6 months, with the need for target lesion revascularization, and with angiographic restenosis (defined as DS ≥50% at follow-up). Logistic regression and receiver operator characteristic curve analyses were applied to determine the prognostic cutoff value of CFR and DS separately and in combination. Optimal cutoff criteria for predictors of these clinical events were DS, 35%; CFR, 2.5. A distal CFR after angioplasty >2.5 with a residual DS ≤35% identified lesions with a low incidence of recurrence of symptoms at 1 month (10% versus 19%, P =.149) and at 6 months (23% versus 47%, P =.005), a low need for reintervention (16% versus 34%, P =.024), and a low restenosis rate (16% versus 41%, P =.002) compared with patients who did not meet these criteria. Conclusions Measurements of distal CFR after PTCA, in combination with DS%, have a predictive value, albeit modest for the short- and long-term outcomes after PTCA, and thus may be used to identify patients who will or will not benefit from additional therapy such as stent implantation. |
| Databáze: | OpenAIRE |
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