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Article

The Impact of Age on the Physiological Assessment of Borderline Coronary Stenoses

by
Wojciech Zasada
1,2,
Barbara Zdzierak
1,
Tomasz Rakowski
1,3,
Beata Bobrowska
1,
Agata Krawczyk-Ożóg
1,4,
Sławomir Surowiec
1,
Stanisław Bartuś
1,3,
Andrzej Surdacki
1,3 and
Artur Dziewierz
1,3,*
1
Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland
2
KCRI, 30-347 Krakow, Poland
3
2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 30-688 Krakow, Poland
4
Department of Anatomy, HEART-Heart Embryology and Anatomy Research Team, Jagiellonian University Medical College, 31-034 Krakow, Poland
*
Author to whom correspondence should be addressed.
Medicina 2023, 59(10), 1863; https://doi.org/10.3390/medicina59101863
Submission received: 4 September 2023 / Revised: 29 September 2023 / Accepted: 17 October 2023 / Published: 19 October 2023
(This article belongs to the Section Cardiology)

Abstract

Background and Objectives: Coronary angiography is the gold standard for diagnosing coronary artery disease (CAD). In the case of borderline changes, patients require further diagnosis through ischemia assessment via one of the recommended methods of invasive evaluation. This study aimed to assess whether clinical factors influence the risk of a positive result in invasive myocardial ischemia assessment and if these potential factors change with the patient’s age and the consistency of ischemia assessment. Materials and Methods: Data were collected retrospectively on all consecutive patients hospitalized in the University Hospital in Krakow between 2020 and 2021, on whom physiological assessments of coronary circulation were performed. Patients were divided into two groups: patients aged 60 or younger and patients older than 60. Results: Despite the older patients having more risk factors for CAD, their physiological assessment results of borderline lesions were similar to those of the younger patients. Positive fractional flow reserve (FFR) assessments were obtained from almost 50% of vessels. In the younger patients, cigarette use and type 2 diabetes mellitus increased the risk of a positive FFR result by 3.5 and 2.5 times, respectively. In the older patients, male gender and peripheral vascular disease significantly increased the risk of a positive FFR by 2.5 and 2 times, respectively. Conclusions: Clinical characteristics of patients undergoing physiological assessment of borderline coronary stenosis varied significantly by age. Refining the definition of borderline lesions to include age, gender, and other factors may improve the identification of patients who would benefit from physiological assessment and coronary revascularization.
Keywords: age; borderline stenoses; fractional flow reserve; instantaneous wave-free ratio; physiological assessment; resting full-cycle ratio age; borderline stenoses; fractional flow reserve; instantaneous wave-free ratio; physiological assessment; resting full-cycle ratio

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MDPI and ACS Style

Zasada, W.; Zdzierak, B.; Rakowski, T.; Bobrowska, B.; Krawczyk-Ożóg, A.; Surowiec, S.; Bartuś, S.; Surdacki, A.; Dziewierz, A. The Impact of Age on the Physiological Assessment of Borderline Coronary Stenoses. Medicina 2023, 59, 1863. https://doi.org/10.3390/medicina59101863

AMA Style

Zasada W, Zdzierak B, Rakowski T, Bobrowska B, Krawczyk-Ożóg A, Surowiec S, Bartuś S, Surdacki A, Dziewierz A. The Impact of Age on the Physiological Assessment of Borderline Coronary Stenoses. Medicina. 2023; 59(10):1863. https://doi.org/10.3390/medicina59101863

Chicago/Turabian Style

Zasada, Wojciech, Barbara Zdzierak, Tomasz Rakowski, Beata Bobrowska, Agata Krawczyk-Ożóg, Sławomir Surowiec, Stanisław Bartuś, Andrzej Surdacki, and Artur Dziewierz. 2023. "The Impact of Age on the Physiological Assessment of Borderline Coronary Stenoses" Medicina 59, no. 10: 1863. https://doi.org/10.3390/medicina59101863

APA Style

Zasada, W., Zdzierak, B., Rakowski, T., Bobrowska, B., Krawczyk-Ożóg, A., Surowiec, S., Bartuś, S., Surdacki, A., & Dziewierz, A. (2023). The Impact of Age on the Physiological Assessment of Borderline Coronary Stenoses. Medicina, 59(10), 1863. https://doi.org/10.3390/medicina59101863

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