[1]戴东普,赵晓燕#,王小芳.PCI和药物治疗血流储备分数处于临界值的单纯左前降支近端中度狭窄效果的比较[J].郑州大学学报(医学版),2013,(05):681.
 DAI Dongpu,ZHAO Xiaoyan,WANG Xiaofang.Comparison of PCI and medical treatment for moderate stenosis in isolated proximal left anterior descending coronary artery patients with fractional flow reserve at critical value[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2013,(05):681.
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PCI和药物治疗血流储备分数处于临界值的单纯左前降支近端中度狭窄效果的比较
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《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2013年05期
页码:
681
栏目:
应用研究
出版日期:
2013-09-02

文章信息/Info

Title:
Comparison of PCI and medical treatment for moderate stenosis in isolated proximal left anterior descending coronary artery patients with fractional flow reserve at critical value
作者:
戴东普赵晓燕#王小芳
郑州大学第一附属医院心血管内科 郑州 450052
Author(s):
DAI DongpuZHAO XiaoyanWANG Xiaofang
Department of Cardiology,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052
关键词:
血流储备分数左前降支近端中度狭窄介入治疗药物治疗
Keywords:
fractional flow reserve left anterior descending coronary artery moderate stenosis PCI medical therapy
分类号:
R453.9
摘要:
目的:探讨血流储备分数(FFR)处于临界值的单纯左前降支近端中度狭窄患者治疗方案的选择。 方法:选择 50例冠状动脉造影显示单纯左前降支近端中度狭窄(50%~70%)且FFR处于临界值(0.75~0.80)的患者,分为两组,一组行经皮冠状动脉介入(PCI)治疗,另一组行药物保守治疗。随访2 a,观察两组患者主要不良心血管事件(心源性猝死、非致死性心肌梗死、再行PCI)的发生率及2 a后左前降支近端的狭窄程度。 结果:PCI治疗组和药物治疗组主要不良心血管事件的发生率分别为9.1% (2/22)和10.7% (3/28),差异无统计学意义(P>0.999);2 a后血管狭窄程度分别降低了(9±2)%和(8±3)%,差异亦无统计学意义(t=0.492,P>0.05)。结论:FFR处于临界值的单纯左前降支近端中度狭窄患者介入治疗和药物保守治疗的近期预后无差别。
Abstract:
Aim: To compare the efficacy of PCI and medical treatment for moderate stenosis in isolated proximal left anterior descending coronary artery patients with fractional flow reserve at critical value.Methods:Fifty patients, who had isolated proximal left anterior descending coronary artery moderate stenosis(50%-70%)with intermediate fractional flow reserve between 0.75 and 0.80, were enrolled.Twentytwo patients(PCI group) were treated with PCI combined with optimal medical therapy, and the other 28 patients(medicaltherapy group) were treated by optimal medical therapy.After a 2year followup, the occurrence of the major adverse cardiovascular events(MACE) and the stenosis rate of the proximal left anterior descending coronary artery were observed. Results: The occurrence of MACE of PCI group and the medicaltherapy group was 9.1% and 10.7%, the stenosis rates decreased by (9±2)% and (8±3)%,and there were no differences between the two groups(t=0.492,P>0.05).Conclusion: For patients with moderate stenosis and intermediate fractional flow reserve(0.75-0.80), there is no difference in efficacy of PCI and medicaltherapy.

参考文献/References:

[1]Kern MJ,Lerman A,Bech JW,et al. Physiological assessment of coronary artery disease in the cardiac catheterization laboratory: a scientific statement from the American Heart Association Committee on Diagnostic and Interventional Cardiac Catheterization, Council on Clinical Cardiology[J]. Circulation, 2006,114(12):1321
[2]Kern MJ ,Samady H. Current concepts of integrated coronary physiology in the catheterization laboratory[J]. J Am Coll Cardiol, 2010, 55(3):173
[3]Park SJ, Ahn JM, Kang SJ. Paradigm shift to functional angioplasty: new insights for fractional flow reserve and intravascular ultrasoundguided percutaneous coronary intervention[J]. Circulation, 2011,124(8): 951
[4]Puymirat E, Muller O, Sharif F, et al.Fractional flow reserve:concepts, applications and use in France in 2010[J].Arch Cardiovasc Dis, 2010,103(11/12):615
[5]Verna E,Lattanzio M,Ghiringhelli S,et al.Performing versus deferring coronary angioplasty based an functional evaluation of vessel stenosis by pressure measurements:a clinical outcome study[J].J Cardiovasc Med, 2006,7(3):169
[6]Dijls NH, Van Schaardenburgh P,Manoharan G,et al.Percutaneous Coronary intervention of functionally nonsignificant stenosis: 5year followup of the DEFFER study[J].J Am Coll Cardiol, 2007,49(2):2105
[7]Muller O,Mangiacapra F,Ntalianis A,et al.Longterm followup after fractional flow reserveguided treatment strategy in patients with an isolated proximal left anterior descending coronary artery stenosis[J].JACC Cardiovasc Interv,2011,4(11):1175
[8]Lindstaedt M,Halilcavusogullari Y, Yazar A,et al.Clinical outcome following conservative vs revascularization therapy in patients with stable coronary artery disease and borderline fractional flow reserve measurements[J].Clin Cardiol, 2010, 33(2):77
[9]Courtis J,RodesCabau J,Larose E,et al.Comparison of medical treatment and coronary revascularization in patients with moderate coronary lesions and borderline fractional flow reserve measurements[J].Catheter Cardiorasc Interv, 2008, 71(4):541
[10]Tani S,Watanabe I,Kobari C,et al.Mismatch between results of myocardial fractional flow reserve (FFR) measurements and myocardial perfusion SPECT for identification of the severity of ischemia[J].Jpn Heart J,2004,45(5):867

更新日期/Last Update: 2013-09-01