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논문 기본 정보

자료유형
학술저널
저자정보
Jung-Hee Lee (Yonsei University Wonju College of Medicine) Sung Gyun Ahn (Yonsei University Wonju College of Medicine) Ho Sung Jeon (Yonsei University Wonju College of Medicine) Jun-Won Lee (Yonsei University Wonju College of Medicine) Young Jin Youn (Yonsei University Wonju College of Medicine) Jinlong Zhang (The Second Affiliated Hospital Zhejiang University School of Medicine) Xinyang Hu (The Second Affiliated Hospital Zhejiang University School of Medicine) Jian’an Wang (The Second Affiliated Hospital Zhejiang University School of Medicine) Joo Myung Lee (Samsung Medical Center) Joo-Yong Hahn (Samsung Medical Center) Chang-Wook Nam (Keimyung University Dongsan Medical Center) Joon-Hyung Doh (Inje University Ilsan Paik Hospital) Bong-Ki Lee (Kangwon National University Hospital) Weon Kim (Kyung Hee University Hospital) Jinyu Huang (Affiliated Hangzhou First People’s Hospital) Fan Jiang (Hangzhou Normal University Affiliated Hospital) Hao Zhou (The 1st Affiliated Hospital of Wenzhou Medical University) Peng Chen (The 2nd Affiliated Hospital of Wenzhou Medical University) Lijiang Tang (Zhejiang Hospital) Wenbing Jiang (The Third Clinical Institute Affiliated To Wenzhou Medical University) Xiaomin Chen (Ningbo First Hospital) Wenming He (The Affiliated Hospital of Medical School of Ningbo University) Myeong-Ho Yoon (Ajou University Hospital) Seung-Jea Tahk (Ajou University Hospital) Ung Kim (Yeungnam University Medical Center) You-Jeong Ki (Uijeongbu Eulji Medical Center) Eun-Seok Shin (Ulsan University Hospital) Doyeon Hwang (Seoul National University Hospital) Jeehoon Kang (Seoul National University Hospital) Hyo-Soo Kim (Seoul National University Hospital) Bon-Kwon Koo (Seoul National University Hospital)
저널정보
대한심장학회 Korean Circulation Journal Korean Circulation Journal Vol.54 No.8
발행연도
2024.8
수록면
485 - 496 (12page)
DOI
https://doi.org/10.4070/kcj.2024.0046

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초록· 키워드

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Background and Objectives: Angiographic assessment of coronary stenosis severity using quantitative coronary angiography (QCA) is often inconsistent with that based on fractional flow reserve (FFR) or intravascular ultrasound (IVUS). We investigated the incidence of discrepancies between QCA and FFR or IVUS, and the outcomes of FFR- and IVUS-guided strategies in discordant coronary lesions. Methods: This study was a post-hoc analysis of the FLAVOUR study. We used a QCA-derived diameter stenosis (DS) of 60% or greater, the highest tertile, to classify coronary lesions as concordant or discordant with FFR or IVUS criteria for percutaneous coronary intervention (PCI). The patient-oriented composite outcome (POCO) was defined as a composite of death, myocardial infarction, or revascularization at 24 months. Results: The discordance rate between QCA and FFR or IVUS was 30.2% (n=551). The QCA-FFR discordance rate was numerically lower than the QCA-IVUS discordance rate (28.2% vs. 32.4%, p=0.050). In 200 patients with ≥60% DS, PCI was deferred according to negative FFR (n=141) and negative IVUS (n=59) (15.3% vs. 6.5%, p<0.001). The POCO incidence was comparable between the FFR- and IVUS-guided deferral strategies (5.9% vs. 3.4%, p=0.479). Conversely, 351 patients with DS <60% underwent PCI according to positive FFR (n=118) and positive IVUS (n=233) (12.8% vs. 25.9%, p<0.001). FFR- and IVUS-guided PCI did not differ in the incidence of POCO (9.5% vs. 6.5%, p=0.294). Conclusions: The proportion of QCA-FFR or IVUS discordance was approximately one third for intermediate coronary lesions. FFR- or IVUS-guided strategies for these lesions were comparable with respect to POCO at 24 months.
#Fractional flow reserve #myocardial #Ultrasonography #interventional #Percutaneous coronary intervention #Treatment outcome

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