Three-year clinical outcomes of a fractional flow reserve-guided percutaneous coronary intervention (PCI) strategy: A comparison of nicorandil and ATP

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2025-05-27 DOI:10.1016/j.ijcha.2025.101708

Yuki Numajiri , Daisuke Wada , Yuki Ishii , Yuka Tanizaki , Yosuke Takei , Hiromoto Sone , Kazuma Tashiro , Takuya Mizukami , Tokutada Sato , Takaaki Matsuyama , Hiroshi Suzuki , Hiroyoshi Mori

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引用次数: 0

Abstract

Background

Nicorandil is used to induce hyperemia when measuring fractional flow reserve (FFR). However, it is unknown whether the clinical outcome of patients assessed using nicorandil is similar to that of patients assessed using adenosine triphosphatase (ATP). We aimed to compare the clinical outcomes of nicorandil and ATP in the PCI and deferred groups.

Methods

This retrospective study examined 492 patients with chronic coronary syndrome who underwent FFR assessment between February 2016 and December 2021. The patients received either nicorandil or ATP to induce hyperemia. The primary endpoints were all-cause death, myocardial infarction, and urgent revascularization. These clinical outcomes were followed up for three years and compared between the groups.

Results

In the PCI group (161 patients), primary endpoint events occurred in 9 % of the nicorandil group and 11 % of the ATP group (Adjusted HR 1.10, 95 % CI 0.35–3.40, P = 0.87). In the deferred group (331 patients), primary events occurred in 7 % of the patients in both groups (Adjusted HR 1.39, 95 % CI 0.55–3.49, P = 0.49). Kaplan-Meier curves showed no significant differences in event rates between nicorandil and ATP in either group.

Conclusions

In the evaluation of FFR, nicorandil is a safe and simple alternative that shows similar clinical outcomes to ATP.

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分流血流储备引导下经皮冠状动脉介入治疗（PCI）策略的三年临床结果：尼可地尔和ATP的比较

在测量部分血流储备（FFR）时，nicorandil被用于诱导充血。然而，目前尚不清楚使用尼可地尔评估的患者的临床结果是否与使用三磷酸腺苷酶（ATP）评估的患者相似。我们的目的是比较尼可地尔和ATP在PCI组和延期组的临床结果。方法本回顾性研究调查了2016年2月至2021年12月期间接受FFR评估的492例慢性冠状动脉综合征患者。患者接受尼可地尔或ATP诱导充血。主要终点为全因死亡、心肌梗死和紧急血运重建术。这些临床结果被随访了三年，并在两组之间进行比较。结果在PCI组（161例）中，尼可地尔组的主要终点事件发生率为9%，ATP组的主要终点事件发生率为11%（调整后HR为1.10,95% CI为0.35 ~ 3.40,P = 0.87）。在延迟治疗组（331例患者），两组中均有7%的患者发生原发事件（调整后风险比1.39,95% CI 0.55-3.49, P = 0.49）。Kaplan-Meier曲线显示，在两组中，尼可地尔和ATP的事件发生率无显著差异。结论在评价FFR时，尼可地尔是一种安全、简便的替代药物，其临床效果与ATP相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.