2026-04-29T23:12:18Zhttps://repisalud.isciii.es/rest/oai/requestoai:repisalud.isciii.es:20.500.12105/127422025-05-29T17:20:50Zcom_20.500.12105_19604com_20.500.12105_2051col_20.500.12105_19605
Repisalud
author
Lee, Joo Myung
author
Choi, Ki Hong
author
Doh, Joon Hyung
author
Nam, Chang Wook
author
Shin, Eun Seok
author
Hoshino, Masahiro
author
Murai, Tadashi
author
Yonetsu, Taishi
author
Mejía-Rentería, Hernán
author
Kakuta, Tsunekazu
author
Escaned, Javier
author
Koo, Bon-Kwon
2021-04-23T08:59:00Z
2021-04-23T08:59:00Z
2020-10
Korean Circ J. 2020; 50(9):e101
10.4070/kcj.2020.0083
1738-5520
Korean circulation journal
32725991
http://hdl.handle.net/20.500.12105/12742
Recent guideline recommends evaluation using of coronary flow reserve (CFR) and index of microcirculatory resistance (IMR) in patients with functionally insignificant stenosis. We evaluated clinical implications of CFR and IMR in patients with high fractional flow reserve (FFR) and deferred revascularization.
A total of 867 patients (1,152 vessels) consigned to deferred revascularization who underwent comprehensive physiologic assessments were enrolled. Patients with high FFR (>0.80) were categorized by CFR (≤2) and IMR (≥23 U). Clinical outcome was assessed by patient-oriented composite outcome (POCO), a composite of any death, myocardial infarction (MI), and revascularization at 5 years.
Patients with low CFR (≤2) showed significantly greater risk of POCO than those with high CFR (>2) in both high-FFR (p=0.024) and low-FFR (p=0.034) groups. In patients with high FFR, those with low CFR and high IMR (overt microvascular disease) displayed the greatest risk of POCO overall (p=0.015), surpassing those with high CFR and low IMR (HR, 2.873; 95% CI, 1.476-5.594; p=0.002) and showing significantly greater risk of cardiac death or MI (HR, 5.662; 95% CI, 1.984-16.154; p=0.001). Overt microvascular disease was independently associated with POCO in the high-FFR population (HR, 2.282; 95% CI, 1.176-4.429; p=0.015).
Among patients with deferred revascularization, those with low CFR showed significantly greater risk of POCO than those with high CFR, regardless of FFR. In patients with high FFR, those with overt microvascular disease showed significantly greater risk of POCO and cardiac death or MI at 5-year, compared with the others.
ClinicalTrials.gov Identifier: NCT03690713.
eng
Myocardial ischemia
Coronary artery disease
Fractional flow reserve
Coronary flow reserve
Index of microcirculatory resistance
Percutaneous coronary intervention
Long-term Patient Prognostication by Coronary Flow Reserve and Index of Microcirculatory Resistance: International Registry of Comprehensive Physiologic Assessment
journal article
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LongTermPatientPrognostication_2020.pdf
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LongTermPatientPrognostication_2020.7z
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LongTermPatientPrognostication_2020.pdf.txt