基于默里定律的血管造影定量血流比与1年冠状动脉搭桥术通畅的关系

IF 11.4 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions Pub Date : 2025-10-13 DOI:10.1016/j.jcin.2025.08.027

Ho Young Hwang MD, PhD , Daixin Ding PhD , Jeehoon Kang MD , Pengcheng Sun PhD , Suk Ho Sohn MD, PhD , Shengxian Tu PhD , Bon-Kwon Koo MD, PhD

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引用次数: 0

摘要

评估冠状动脉狭窄决策对冠状动脉旁路移植术（CABG）后结果的功能意义的研究有限。目的评价术前血管造影默里定律（Murray laws）靶冠状动脉定量血流比（μFR）对冠脉搭桥术后1年移植物通畅的预测价值。方法回顾性分析809例因3支血管病变行非体外循环冠状动脉搭桥并进行1年移植物评估的患者。术前获取所有可行靶血管的μFR数据。采用广义线性混合效应模型进行多变量分析。采用最小P值法确定预测移植物通畅程度的最佳μFR截止值。结果研究人群平均年龄为65.9±9.0岁。总共有2324个远端吻合口被纳入分析。早期和1年移植血管闭塞率分别为0.8%（19例/ 2324例，95% CI: 0.5 ~ 1.3例）和5.1%（118例/ 2324例，95% CI: 4.2 ~ 6.1例）。多变量分析表明，μFR与1年移植物通畅程度有显著相关性（OR [95% CI]: 0.847 [0.731-0.982]; P = 0.03），但与早期移植物通畅程度无显著相关性（0.941 [0.746-1.186];P = 0.60）。最小P值法对0.75 ~ 0.78 μFR值的鉴别能力最强，最小P值法对0.77 μFR值的鉴别能力最低。结论靶血管狭窄的功能意义（μFR）与非体外循环冠脉搭桥术后1年冠脉通畅相关，最佳临界值为0.77 （ΜFR与冠脉搭桥结局的相关性；NCT06844721）。

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Association Between Angiography-Derived Murray Law–Based Quantitative Flow Ratio and 1-Year Coronary Artery Bypass Graft Patency

Background

Studies evaluating the impact of functional significance of coronary artery stenosis-based decision-making on results after coronary artery bypass grafting (CABG) are limited.

Objectives

This study was conducted to evaluate the predictive value of preoperative angiography-derived Murray law–based quantitative flow ratio (μFR) of target native coronary arteries on 1-year graft patency following CABG.

Methods

A total of 809 patients who underwent isolated off-pump CABG for 3-vessel disease and 1-year graft evaluation were retrospectively enrolled. Preoperative μFR data were obtained for all feasible target vessels. Multivariable analyses were conducted using generalized linear mixed-effects models. The minimal P value approach was used to determine the optimal cutoff value of the μFR that predicting graft patency.

Results

The mean age of the study population was 65.9 ± 9.0 years. A total of 2,324 distal anastomoses were included in the analysis. Early and 1-year graft occlusion rates were 0.8% (19 of 2,324 anastomoses; 95% CI: 0.5-1.3 anastomoses) and 5.1% (118 of 2,324 anastomoses; 95% CI: 4.2-6.1 anastomoses), respectively. Multivariable analysis demonstrated that μFR was significantly associated with 1-year graft patency (OR [95% CI]: 0.847 [0.731-0.982]; P = 0.03), but not with early graft patency (0.941 [0.746-1.186]; P = 0.60). The minimal P value approach identified μFR values between 0.75 and 0.78 having the strongest discriminative power, with the lowest P value at a μFR of 0.77.

Conclusions

The functional significance of coronary artery stenosis of target vessels, as measured by μFR, is associated with 1-year graft patency after off-pump CABG with an optimal cutoff value of 0.77 (Association Between ΜFR and CABG Outcomes; NCT06844721)

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来源期刊

JACC. Cardiovascular interventions CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

11.60

自引率

8.80%

发文量

756

审稿时长

4-8 weeks

期刊介绍： JACC: Cardiovascular Interventions is a specialist journal launched by the Journal of the American College of Cardiology (JACC). It covers the entire field of interventional cardiovascular medicine, including cardiac, peripheral, and cerebrovascular interventions. The journal publishes studies that will impact the practice of interventional cardiovascular medicine, including clinical trials, experimental studies, and in-depth discussions by respected experts. To enhance visual understanding, the journal is published both in print and electronically, utilizing the latest technologies.