Comparison of Fractional Flow Reserve with Resting Non-Hyperemic Indices in Patients with Coronary Artery Disease
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Value; n = 279 Patients | ||
---|---|---|
Age, years | mean (SD) | 67.55 (10.52) |
Female | N (%) | 70 (25%) |
Height, cm | median (IQR) | 170.00 (11.00) |
Weight, kg | median (IQR) | 84.00 (21.88) |
Body mass index, kg/m2 | median (IQR) | 28.40 (6.67) |
eGFR, mL/min/1.73 m2 | mean (SD) | 76.80 (25.86) |
LVEF, % | median (IQR) | 52.00 (20.00) |
Arterial hypertension | N (%) | 242 (87%) |
Diabetes mellitus | N (%) | 112 (40%) |
Diabetes mellitus-treatment | diet, N (%) oral medications, N (%) insulin, N (%) | 6 (2%) 63 (23%) 44 (16%) |
Atrial fibrillation | N (%) | 55 (20%) |
Previous MI | N (%) | 134 (48%) |
Previous PCI | N (%) | 141 (51%) |
Previous CABG | N (%) | 14 (5%) |
Peripheral vascular disease | N (%) | 42 (15%) |
COPD | N (%) | 18 (6%) |
Stroke/TIA | N (%) | 27 (10%) |
Current smoker | N (%) | 144 (52%) |
Dyslipidemia | N (%) | 218 (78%) |
Number of assessed vessels - per patient | 1 (%) 2 (%) 3 (%) 4 (%) | 169 (61%) 85 (30%) 22 (8%) 3 (1%) |
value, n = 417 vessels | ||
Assessed vessels-location | LAD (%) non-LAD (%) Dg (%) Cx (%) Mg (%) RCA (%) | 249 (60%) 168 (40%) 17 (4%) 81 (19%) 20 (5%) 50 (12%) |
LAD | non-LAD | p-Value | ||||
---|---|---|---|---|---|---|
Cx | Mg | Dg | RCA | |||
FFR, median (Q1–Q3) | 0.78 (0.74–0.84) | 0.86 (0.79–0.91) | <0.0001 | |||
0.87 (0.8–0.92) | 0.88 (0.80–0.91) | 0.76 (0.72–0.82) | 0.86 (0.82–0.91) | <0.0001 * | ||
FFR ≤ 0.80, N (%) | 149 (59.8%) | 51 (30.4%) | <0.0001 | |||
21 (25.9%) | 5 (25.0%) | 13 (76.5%) | 12 (24.0%) | <0.0001 * | ||
iFR/RFR, median (Q1–Q3) | 0.89 (0.84–0.92) | 0.94 (0.88–0.97) | <0.0001 | |||
0.95 (0.89–0.98) | 0.93 (0.90–0.98) | 0.87 (0.81–0.91) | 0.95 (0.91–0.97) | <0.0001 * | ||
iFR/RFR ≤ 0.89, N (%) | 145 (58.2%) | 49 (29.2%) | <0.0001 | |||
23 (28.4%) | 4 (20%) | 11 (64.7%) | 11 (22%) | <0.0001 ** |
FFR- | iFR/RFR- n = 180 (43.2%) | FFR- | iFR/RFR + n = 37 (8.9%) | FFR+ | iFR/RFR- n = 43 (10.3%) | FFR+ | iFR/RFR+ n = 157 (37.6%) | p-Value | |
---|---|---|---|---|---|
Age, years mean (SD) | 67.73 (9.37) | 68.68 (12.00) | 64.35 (9.96) * | 68.13 (10.74) | 0.16 |
Female, N (%) | 60 (33.3%) * | 10 (27.0%) | 6 (14.0%) | 30 (19.1%) | 0.007 |
Height, cm median (IQR) | 170 (11) | 171 (13.25) | 172 (11) | 170 (11) | 0.62 |
Weight, kg median (IQR) | 84 (23) | 85 (16.25) | 89 (20) | 82 (23) | 0.75 |
Body mass index, kg/m2 median (IQR) | 28.39 (7.56) | 28.38 (5.21) | 29.04 (5.89) | 28.44 (6.68) | 0.87 |
eGFR, mL/min/1.73 m2 mean (SD) | 77.31 (26.67) ** | 69.35 (26.84) ** | 88.74 (26.81) * | 77.13 (25.59) | 0.010 |
HbA1c, % median (IQR) | 6.5 (2.7) | 7.2 (4.4) | 8 (4.08) | 6.9 (2.3) | 0.97 |
LVEF, % median (IQR) | 55 (20) | 49.5 (13) | 54 (15) | 51 (21.5) | 0.34 |
Arterial hypertension, N (%) | 159 (88.3%) | 33 (89.2%) | 33 (76.7%) * | 144 (91.7%) | 0.042 |
Diabetes mellitus, N (%) | 63 (35.0%) | 14 (37.8%) | 21 (48.8%) | 74 (47.1%) | 0.10 |
Diabetes mellitus treatment - diet, N (%) - oral medications, N (%) - insulin, N (%) | 3 (1.7%) 40 (22.2%) 22 (12.2%) | ** 1 (2.7%) 3 (8.1%) 10 (27.0%) | 0 (0.0%) 18 (41.9%) 3 (7.0%) | 5 (3.2%) 38 (24.2%) 31 (19.7%) | 0.013 |
Atrial fibrillation, N (%) | 39 (21.7%) | 12 (32.4%) | 9 (20.9%) | 27 (17.2%) | 0.23 |
Previous MI, N (%) | 82 (45.6%) | 20 (54.1%) | 19 (44.2%) | 80 (51.0%) | 0.62 |
Previous PCI, N (%) | 82 (45.6%) | 22 (59.5%) | 19 (44.2%) | 89 (56.7%) | 0.11 |
Previous CABG, N (%) | 12 (6.7%) | 1 (2.7%) | 1 (2.3%) | 5 (3.2%) | 0.55 |
Peripheral vascular disease, N (%) | 20 (11.1%) * | 5 (13.5%) | 4 (9.3%) | 37 (23.6%) | 0.008 |
COPD, N (%) | 12 (6.7%) | 7 (18.9%) | 2 (4.7%) | 11 (7.0%) | 0.16 |
Stroke/TIA, N (%) | 18 (10.0%) | 3 (8.1%) | 3 (7.0%) | 12 (7.6%) | 0.88 |
Current smoker, N (%) | 90 (50.0%) | 18 (48.6%) | 23 (53.5%) | 92 (58.6%) | 0.41 |
Dyslipidemia, N (%) | 144 (80.0%) | 29 (78.4%) | 36 (83.7%) | 114 (72.6%) | 0.50 |
Assessed vessels - number 1, N (%) 2, N (%) 3, N (%) 4, N (%) | *** 59 (32.8%) 88 (48.9%) 30 (16.7%) 3 (1.7%) | * 14 (37.8%) 13 (35.1%) 4 (10.8%) 6 (16.2%) | 21 (48.8%) 13 (30.2%) 9 (20.9%) 0 (0.0%) | 75 (47.8%) 56 (35.7%) 23 (14.6%) 3 (1.9%) | <0.0001 |
Assessed vessels - location LAD, N (%) non-LAD, N (%) - Cx, N (%) - Mg, N (%) - Dg, N (%) - RCA, N (%) | *, ** 77 (42.8%) 103 (57.2%) 54 (30.0%) 14 (7.8%) 2 (1.1%) 33 (18.3%) | 23 (62.2%) 14 (37.8%) 6 (16.2%) 1 (2.7%) 2 (5.4%) 5 (13.5%) | 27 (62.8%) 16 (37.2%) 4 (9.3%) 2 (4.7%) 4 (9.3%) 6 (14.0%) | 122 (77.7%) 35 (22.3%) 17 (10.8%) 3 (1.9%) 9 (5.7%) 6 (3.8%) | <0.0001 |
Univariate Analysis OR (95% Confidence Interval) | p-Value | Multivariate Analysis OR (95% Confidence Interval) | p-Value | |
---|---|---|---|---|
Predictors of FFR+ | iFR/RFR− | ||||
Age (per 1 year) | 0.96 (0.93–0.99) | 0.029 | 0.96 (0.93–0.99) | 0.024 |
LVEF (per 1%) | 1.01 (0.98–1.04) | 0.30 | 1.02 (0.98-1.04) | 0.22 |
Predictors of FFR− | iFR/RFR+ | ||||
DM treatment (insulin vs. others) | 4.64 (1.39–15.48) | 0.013 | 4.61 (1.38–15.40) | 0.013 |
eGFR (per 1 mL/min/1.73 m2) | 0.98 (0.97–0.99) | 0.046 | 0.99 (0.97–1.02) | 0.69 |
Predictors of overall FFR and iFR/RFR discordance | ||||
Age (per 1 year) | 0.99 (0.96–1.01) | 0.22 | 0.98 (0.95–1.01) | 0.06 |
LVEF (per 1%) | 1.01 (0.99–1.03) | 0.28 | 1.01 (0.99–1.03) | 0.15 |
Atrial fibrillation | 1.46 (0.83–2.56) | 0.20 | 1.90 (1.02–3.51) | 0.040 |
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Zdzierak, B.; Zasada, W.; Krawczyk-Ożóg, A.; Rakowski, T.; Bartuś, S.; Surdacki, A.; Dziewierz, A. Comparison of Fractional Flow Reserve with Resting Non-Hyperemic Indices in Patients with Coronary Artery Disease. J. Cardiovasc. Dev. Dis. 2023, 10, 34. https://doi.org/10.3390/jcdd10020034
Zdzierak B, Zasada W, Krawczyk-Ożóg A, Rakowski T, Bartuś S, Surdacki A, Dziewierz A. Comparison of Fractional Flow Reserve with Resting Non-Hyperemic Indices in Patients with Coronary Artery Disease. Journal of Cardiovascular Development and Disease. 2023; 10(2):34. https://doi.org/10.3390/jcdd10020034
Chicago/Turabian StyleZdzierak, Barbara, Wojciech Zasada, Agata Krawczyk-Ożóg, Tomasz Rakowski, Stanisław Bartuś, Andrzej Surdacki, and Artur Dziewierz. 2023. "Comparison of Fractional Flow Reserve with Resting Non-Hyperemic Indices in Patients with Coronary Artery Disease" Journal of Cardiovascular Development and Disease 10, no. 2: 34. https://doi.org/10.3390/jcdd10020034