用于指导血管造影中复杂和非复杂冠状动脉狭窄治疗的部分流量储备或近距离观察

IF 5.9 2区 医学 Q2 Medicine
Andrea Zito , Francesco Burzotta , Cristina Aurigemma , Enrico Romagnoli , Francesco Bianchini , Emiliano Bianchini , Lazzaro Paraggio , Mattia Lunardi , Carolina Ierardi , Filippo Crea , Antonio Maria Leone , Carlo Trani
{"title":"用于指导血管造影中复杂和非复杂冠状动脉狭窄治疗的部分流量储备或近距离观察","authors":"Andrea Zito ,&nbsp;Francesco Burzotta ,&nbsp;Cristina Aurigemma ,&nbsp;Enrico Romagnoli ,&nbsp;Francesco Bianchini ,&nbsp;Emiliano Bianchini ,&nbsp;Lazzaro Paraggio ,&nbsp;Mattia Lunardi ,&nbsp;Carolina Ierardi ,&nbsp;Filippo Crea ,&nbsp;Antonio Maria Leone ,&nbsp;Carlo Trani","doi":"10.1016/j.recesp.2025.02.016","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The management of patients with coronary artery disease can benefit from devices that improve functional or anatomical evaluation. This study aimed to compare the efficacy of optical coherence tomography (OCT) and fractional flow reserve (FFR) guidance for managing vessels with angiographically intermediate coronary lesions according to angiographic lesion complexity.</div></div><div><h3>Methods</h3><div>The FORZA trial (<span><span>NCT01824030</span><svg><path></path></svg></span>) was a randomized trial comparing the use of OCT or FFR for revascularization decisions and percutaneous coronary intervention optimization in patients with angiographically intermediate coronary lesions. Complex lesions were defined as long (length &gt;<!--> <!-->38<!--> <!-->mm), severely calcified, or bifurcation lesions. The primary outcome was major adverse cardiac events (MACE), defined as a composite of all-cause death, myocardial infarction, or target vessel revascularization.</div></div><div><h3>Results</h3><div>A total of 420 vessels (200 OCT-guided and 220 FFR-guided) were enrolled, including 212 vessels with complex lesions. At the 5-year follow-up, the MACE rate was 20.8% in vessels with complex lesions and 13.9% in vessels with noncomplex lesions (HR, 1.52; 95%<span>C</span>I, 0.95-2.44; <em>P</em> <!-->=<!--> <!-->.078). Compared with FFR, OCT was associated with a lower risk of MACE in vessels with complex lesions (HR, 0.53; 95%CI, 0.28-0.98; <em>P</em> <!-->=<!--> <!-->.044), but with a higher risk of MACE in vessels with noncomplex lesions (HR, 2.23; 95%CI, 1.04-4.81; <em>P</em> <!-->=<!--> <!-->.040; <em>P</em><sub>interaction</sub> <!-->=<!--> <!-->.004).</div></div><div><h3>Conclusions</h3><div>In vessels with angiographically intermediate coronary lesions, angiographic lesion complexity may modulate the long-term efficacy of the guidance modality, with a potential benefit of OCT in complex lesions and FFR in noncomplex lesions.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 10","pages":"Pages 876-885"},"PeriodicalIF":5.9000,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Reserva fraccional de flujo u OCT para guiar el tratamiento de estenosis coronarias complejas y no complejas angiográficamente intermedias\",\"authors\":\"Andrea Zito ,&nbsp;Francesco Burzotta ,&nbsp;Cristina Aurigemma ,&nbsp;Enrico Romagnoli ,&nbsp;Francesco Bianchini ,&nbsp;Emiliano Bianchini ,&nbsp;Lazzaro Paraggio ,&nbsp;Mattia Lunardi ,&nbsp;Carolina Ierardi ,&nbsp;Filippo Crea ,&nbsp;Antonio Maria Leone ,&nbsp;Carlo Trani\",\"doi\":\"10.1016/j.recesp.2025.02.016\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction and objectives</h3><div>The management of patients with coronary artery disease can benefit from devices that improve functional or anatomical evaluation. This study aimed to compare the efficacy of optical coherence tomography (OCT) and fractional flow reserve (FFR) guidance for managing vessels with angiographically intermediate coronary lesions according to angiographic lesion complexity.</div></div><div><h3>Methods</h3><div>The FORZA trial (<span><span>NCT01824030</span><svg><path></path></svg></span>) was a randomized trial comparing the use of OCT or FFR for revascularization decisions and percutaneous coronary intervention optimization in patients with angiographically intermediate coronary lesions. Complex lesions were defined as long (length &gt;<!--> <!-->38<!--> <!-->mm), severely calcified, or bifurcation lesions. The primary outcome was major adverse cardiac events (MACE), defined as a composite of all-cause death, myocardial infarction, or target vessel revascularization.</div></div><div><h3>Results</h3><div>A total of 420 vessels (200 OCT-guided and 220 FFR-guided) were enrolled, including 212 vessels with complex lesions. At the 5-year follow-up, the MACE rate was 20.8% in vessels with complex lesions and 13.9% in vessels with noncomplex lesions (HR, 1.52; 95%<span>C</span>I, 0.95-2.44; <em>P</em> <!-->=<!--> <!-->.078). Compared with FFR, OCT was associated with a lower risk of MACE in vessels with complex lesions (HR, 0.53; 95%CI, 0.28-0.98; <em>P</em> <!-->=<!--> <!-->.044), but with a higher risk of MACE in vessels with noncomplex lesions (HR, 2.23; 95%CI, 1.04-4.81; <em>P</em> <!-->=<!--> <!-->.040; <em>P</em><sub>interaction</sub> <!-->=<!--> <!-->.004).</div></div><div><h3>Conclusions</h3><div>In vessels with angiographically intermediate coronary lesions, angiographic lesion complexity may modulate the long-term efficacy of the guidance modality, with a potential benefit of OCT in complex lesions and FFR in noncomplex lesions.</div></div>\",\"PeriodicalId\":21299,\"journal\":{\"name\":\"Revista espanola de cardiologia\",\"volume\":\"78 10\",\"pages\":\"Pages 876-885\"},\"PeriodicalIF\":5.9000,\"publicationDate\":\"2025-05-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Revista espanola de cardiologia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0300893225012254\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista espanola de cardiologia","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0300893225012254","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0

摘要

介绍和目的冠状动脉疾病患者的治疗可以从改善功能或解剖评价的器械中获益。本研究旨在比较光学相干断层扫描(OCT)和分数血流储备(FFR)指导根据血管造影病变复杂性对冠脉造影中期病变血管的治疗效果。方法FORZA试验(NCT01824030)是一项随机试验,比较使用OCT或FFR进行血管重建决策和经皮冠状动脉介入治疗对血管造影中期冠状动脉病变患者的影响。复杂病变被定义为长(长度>; 38mm),严重钙化或分叉病变。主要终点是主要心脏不良事件(MACE),定义为全因死亡、心肌梗死或靶血管重建术的综合结果。结果共纳入420条血管(oct引导200条,ffr引导220条),其中病变复杂的血管212条。在5年随访中,复杂病变血管的MACE率为20.8%,非复杂病变血管的MACE率为13.9% (HR, 1.52; 95%CI, 0.95-2.44; P = 0.078)。与FFR相比,OCT与复杂病变血管发生MACE的风险较低(HR, 0.53; 95%CI, 0.28-0.98; P = 0.044),但与非复杂病变血管发生MACE的风险较高(HR, 2.23; 95%CI, 1.04-4.81; P = 0.040; P相互作用= 0.004)。结论在冠状动脉造影中度病变的血管中,血管造影病变复杂性可能调节引导方式的长期疗效,在复杂病变中OCT和非复杂病变中FFR具有潜在的优势。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reserva fraccional de flujo u OCT para guiar el tratamiento de estenosis coronarias complejas y no complejas angiográficamente intermedias

Introduction and objectives

The management of patients with coronary artery disease can benefit from devices that improve functional or anatomical evaluation. This study aimed to compare the efficacy of optical coherence tomography (OCT) and fractional flow reserve (FFR) guidance for managing vessels with angiographically intermediate coronary lesions according to angiographic lesion complexity.

Methods

The FORZA trial (NCT01824030) was a randomized trial comparing the use of OCT or FFR for revascularization decisions and percutaneous coronary intervention optimization in patients with angiographically intermediate coronary lesions. Complex lesions were defined as long (length > 38 mm), severely calcified, or bifurcation lesions. The primary outcome was major adverse cardiac events (MACE), defined as a composite of all-cause death, myocardial infarction, or target vessel revascularization.

Results

A total of 420 vessels (200 OCT-guided and 220 FFR-guided) were enrolled, including 212 vessels with complex lesions. At the 5-year follow-up, the MACE rate was 20.8% in vessels with complex lesions and 13.9% in vessels with noncomplex lesions (HR, 1.52; 95%CI, 0.95-2.44; P = .078). Compared with FFR, OCT was associated with a lower risk of MACE in vessels with complex lesions (HR, 0.53; 95%CI, 0.28-0.98; P = .044), but with a higher risk of MACE in vessels with noncomplex lesions (HR, 2.23; 95%CI, 1.04-4.81; P = .040; Pinteraction = .004).

Conclusions

In vessels with angiographically intermediate coronary lesions, angiographic lesion complexity may modulate the long-term efficacy of the guidance modality, with a potential benefit of OCT in complex lesions and FFR in noncomplex lesions.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Revista espanola de cardiologia
Revista espanola de cardiologia 医学-心血管系统
CiteScore
4.20
自引率
13.60%
发文量
257
审稿时长
28 days
期刊介绍: Revista Española de Cardiología, Revista bilingüe científica internacional, dedicada a las enfermedades cardiovasculares, es la publicación oficial de la Sociedad Española de Cardiología.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信