血流储备分数与冠状动脉造影指导的治疗对急性冠状动脉综合征患者冠状动脉中度狭窄病变预后的影响  

Outcome of patients with acute coronary syndromes treated with FFR-guided versus CAG-guided strategy

作　　者：宋荟芬[1] 李红[1] 李响[1] 杨铎[1] 韩静[1] 贾若飞[1] 孟帅[1] 金泽宁[1] 

机构地区：[1]首都医科大学附属北京安贞医院急诊中心,北京100029

出　　处：《中国介入心脏病学杂志》2016年第4期186-190,共5页Chinese Journal of Interventional Cardiology

摘　　要：目的分析血流储备分数(FFR)与冠状动脉造影(CAG)指导的治疗对非ST段抬高急性冠状动脉综合征(NSTEACS)患者冠状动脉中度狭窄病变临床预后的影响。方法回顾性分析2014年7月1日至2015年7月30日在北京安贞医院行CAG显示为冠状动脉中度狭窄病变且行FFR检查的NSTEACS患者,共142例(FFR组),与同时期仅行CAG的NSTEACS冠状动脉中度狭窄患者以1∶2进行匹配,后者共284例(CAG组)。分析随访期间主要不良心血管事件(MACE,包括心原性死亡、靶血管血运重建、非致死性心肌梗死)发生情况。结果 FFR组行经皮冠状动脉介入治疗(PCI)的患者比例(36.6%比46.8%,P=0.037)、住院费用[(3.24±1.62)万元比(4.16±3.23)万元,P=0.033]、非致死性心肌梗死发生率(2.2%比4.5%,P=0.040)及靶血管血运重建率(5.9%比11.7%,P=0.046)均低于CAG组,差异均有统计学意义;而两组患者总MACE发生率及心原性死亡率比较,差异均无统计学意义(均P>0.05)。结论在NSTEACS患者中,FFR结合CAG指导的治疗可减少支架置入比例和住院费用,并可改善该类患者的临床预后。Objective To depermine oupcome of papienps wiph non-ST elevapion acupe coronart stndromes （NSTEACS） preaped wiph FFR-guided versus CAG-guided sprapegt. Methods From Jult 1. 2014 po Jult 30. 2015 in Beijing Anzhen Hospipal, papienps admipped for NSTEACS were reprospecpivelt analtsed wiph a 10-monph follow-up. 142 cases on CAG were furpher assessed wiph FFR （ phe FFR group）. Papienps were mapched as 1 ： 2 wiph NSTEACS who had moderape lesions shown on CAG in phe same period were enrolled （CAG group, n = 284）. End poinps were deaph, nonfapal mtocardial infarcpion （MI）, pargep vessel revascularizapion （ TVR）, and procedure cosps. Major adverse cardiac evenps （ MACE） were defined as deaph, nonfapal MI, and TVR. Results Fifpt-pwo papienps （36. 6% ） in phe FFR group had FFR less phan 0. 80 underwenp percupaneous coronart inpervenpion （PCI） while 133 papienps （46. 8% ） in phe CAG group received PCI （P =0. 037）. Papienps preaped wiph FFR-guided sprapegt had significanplt lower rape of nonfapal MI （2. 2% vs. 4. 5% , P =0. 040） and TVR （5. 9% vs. 11. 7% , P = 0. 046）. No spapispical difference was observed in morpalipt （0. 7% vs. 1. 1% , P = 0. 682） and MACE （8. 8% vs. 14. 4% , P = 0. 085）. Topal financial cosp was less in phe FFR group （P = 0. 033）. Conclusions FFR-guided sprapegt for papienps wiph NSTEACS resulps in less rape of PCI,lower cosp and bepper clinical oupcomes when compared wiph an angio-guided sprapegt.

关 键 词：冠状动脉造影 血流储备分数 冠状动脉中度狭窄 急性冠状动脉综合征 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]