Lili Liu, Fenghua Ding, Juan Luis Gutiérrez-Chico, Jinzhou Zhu, Zhengbin Zhu, Run Du, Zhenkun Yang, Jian Hu, Shengxian Tu, Ruiyan Zhang
{"title":"药物包被球囊术后μQFR对支架内再狭窄治疗的预后价值。","authors":"Lili Liu, Fenghua Ding, Juan Luis Gutiérrez-Chico, Jinzhou Zhu, Zhengbin Zhu, Run Du, Zhenkun Yang, Jian Hu, Shengxian Tu, Ruiyan Zhang","doi":"10.5603/CJ.a2021.0154","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Investigating the prognostic value of the Murray law-based quantitative flow ratio (μQFR) on the clinical outcome after treatment of in-stent restenosis (ISR) with a drug-coated balloon (DCB).</p><p><strong>Methods: </strong>Patients participating in a previous randomized clinical trial for DCB-ISR were post-hoc analyzed. The primary endpoint was vessel-oriented composite endpoint (VOCE), defined as cardiac death, target vessel-related myocardial infarction, and ischemia-driven target vessel revascularization. μQFRs at baseline and after DCB angioplasty was calculated, and its prognostic value as a predictor of VOCE was explored in Cox regression.</p><p><strong>Results: </strong>A total of 169 lesions in 169 patients were analyzed. At 1-year follow-up, 20 VOCEs occurred in 20 patients. Receiver-operating characteristic curve analysis identified a post-procedural μQFR of ≤ 0.89 as the best cut-off to predict VOCE (area under curve [AUC]: 0.74; 95% confidence interval [CI]: 0.67-0.80; p < 0.001), superior to post-procedural in-stent percent diameter stenosis, which reported an AUC of 0.61 (95% CI: 0.53-0.68; p = 0.18). Post-procedural μQFR was significantly lower in patients with VOCE compared with those without (0.88 [interquartile range: 0.79-0.94] vs. 0.96 [interquartile range: 0.91-0.98], respectively; p < 0.001). After correction for potential confounders, post-procedural μQFR ≤ 0.89 was associated with a 6-fold higher risk of VOCE than lesions with μQFR > 0.89 (hazard ratio: 5.94; 95% CI: 2.33-15.09; p < 0.001).</p><p><strong>Conclusions: </strong>Post-procedural μQFR may become a promising predictor of clinical outcome after treatment of DES-ISR lesions by DCB angioplasty.</p>","PeriodicalId":9492,"journal":{"name":"Cardiology journal","volume":"30 2","pages":"167-177"},"PeriodicalIF":2.5000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4d/91/cardj-30-2-167.PMC10129249.pdf","citationCount":"5","resultStr":"{\"title\":\"Prognostic value of post-procedural μQFR for drug-coated balloons in the treatment of in-stent restenosis.\",\"authors\":\"Lili Liu, Fenghua Ding, Juan Luis Gutiérrez-Chico, Jinzhou Zhu, Zhengbin Zhu, Run Du, Zhenkun Yang, Jian Hu, Shengxian Tu, Ruiyan Zhang\",\"doi\":\"10.5603/CJ.a2021.0154\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Investigating the prognostic value of the Murray law-based quantitative flow ratio (μQFR) on the clinical outcome after treatment of in-stent restenosis (ISR) with a drug-coated balloon (DCB).</p><p><strong>Methods: </strong>Patients participating in a previous randomized clinical trial for DCB-ISR were post-hoc analyzed. The primary endpoint was vessel-oriented composite endpoint (VOCE), defined as cardiac death, target vessel-related myocardial infarction, and ischemia-driven target vessel revascularization. μQFRs at baseline and after DCB angioplasty was calculated, and its prognostic value as a predictor of VOCE was explored in Cox regression.</p><p><strong>Results: </strong>A total of 169 lesions in 169 patients were analyzed. At 1-year follow-up, 20 VOCEs occurred in 20 patients. Receiver-operating characteristic curve analysis identified a post-procedural μQFR of ≤ 0.89 as the best cut-off to predict VOCE (area under curve [AUC]: 0.74; 95% confidence interval [CI]: 0.67-0.80; p < 0.001), superior to post-procedural in-stent percent diameter stenosis, which reported an AUC of 0.61 (95% CI: 0.53-0.68; p = 0.18). Post-procedural μQFR was significantly lower in patients with VOCE compared with those without (0.88 [interquartile range: 0.79-0.94] vs. 0.96 [interquartile range: 0.91-0.98], respectively; p < 0.001). After correction for potential confounders, post-procedural μQFR ≤ 0.89 was associated with a 6-fold higher risk of VOCE than lesions with μQFR > 0.89 (hazard ratio: 5.94; 95% CI: 2.33-15.09; p < 0.001).</p><p><strong>Conclusions: </strong>Post-procedural μQFR may become a promising predictor of clinical outcome after treatment of DES-ISR lesions by DCB angioplasty.</p>\",\"PeriodicalId\":9492,\"journal\":{\"name\":\"Cardiology journal\",\"volume\":\"30 2\",\"pages\":\"167-177\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4d/91/cardj-30-2-167.PMC10129249.pdf\",\"citationCount\":\"5\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cardiology journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5603/CJ.a2021.0154\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiology journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5603/CJ.a2021.0154","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Prognostic value of post-procedural μQFR for drug-coated balloons in the treatment of in-stent restenosis.
Background: Investigating the prognostic value of the Murray law-based quantitative flow ratio (μQFR) on the clinical outcome after treatment of in-stent restenosis (ISR) with a drug-coated balloon (DCB).
Methods: Patients participating in a previous randomized clinical trial for DCB-ISR were post-hoc analyzed. The primary endpoint was vessel-oriented composite endpoint (VOCE), defined as cardiac death, target vessel-related myocardial infarction, and ischemia-driven target vessel revascularization. μQFRs at baseline and after DCB angioplasty was calculated, and its prognostic value as a predictor of VOCE was explored in Cox regression.
Results: A total of 169 lesions in 169 patients were analyzed. At 1-year follow-up, 20 VOCEs occurred in 20 patients. Receiver-operating characteristic curve analysis identified a post-procedural μQFR of ≤ 0.89 as the best cut-off to predict VOCE (area under curve [AUC]: 0.74; 95% confidence interval [CI]: 0.67-0.80; p < 0.001), superior to post-procedural in-stent percent diameter stenosis, which reported an AUC of 0.61 (95% CI: 0.53-0.68; p = 0.18). Post-procedural μQFR was significantly lower in patients with VOCE compared with those without (0.88 [interquartile range: 0.79-0.94] vs. 0.96 [interquartile range: 0.91-0.98], respectively; p < 0.001). After correction for potential confounders, post-procedural μQFR ≤ 0.89 was associated with a 6-fold higher risk of VOCE than lesions with μQFR > 0.89 (hazard ratio: 5.94; 95% CI: 2.33-15.09; p < 0.001).
Conclusions: Post-procedural μQFR may become a promising predictor of clinical outcome after treatment of DES-ISR lesions by DCB angioplasty.
期刊介绍：
Cardiology Journal is a scientific, peer-reviewed journal covering a broad spectrum of topics in cardiology. The journal has been published since 1994 and over the years it has become an internationally recognized journal of cardiological and medical community.
Cardiology Journal is the journal for practicing cardiologists, researchers, and young trainees benefiting from broad spectrum of useful educational content.
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