We have located links that may give you full text access.
Effects of Coronary Revascularisation on Global Coronary Flow Reserve in Stable Coronary Artery Disease.
Cardiovascular Research 2018 July 11
Aims: Coronary flow reserve (CFR) is an integrated measure of the entire coronary vasculature and is a powerful prognostic marker in coronary artery disease (CAD). The extent to which coronary revascularisation can improve CFR is unclear. This study aimed to evaluate the impact of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) on CFR in patients with stable CAD.
Methods and Results: In a prospective, multicentre observational study, CFR was measured by 15O-water positron emission tomography as the ratio of stress to rest myocardial blood flow at baseline and 6 months after optimal medical therapy (OMT) alone, PCI, or CABG. Changes in the SYNTAX and Leaman scores were angiographically evaluated as indicators of completeness of revascularisation. Follow-up was completed by 75 (25 OMT alone, 28 PCI, and 22 CABG) out of 82 patients. The median SYNTAX and Leaman scores, and baseline CFR were 14.5 (interquartile range [IQR]: 8-24.5), 5.5 (IQR: 2.5-12.5), and 1.94 (IQR: 1.67-2.66), respectively. Baseline CFR was negatively correlated with the SYNTAX (ρ = -0.40, P <0.001) and Leaman scores (ρ = -0.33, P=0.004). Overall, only CABG was associated with a significant increase in CFR (1.67 [IQR: 1.14-1.96] vs. 1.98 [IQR: 1.60-2.39], P <0.001). Among patients with CFR<2.0 (n=41), CFR significantly increased in the PCI (1.70 [IQR: 1.42-1.79] vs. 2.21 [IQR: 1.78-2.49], P=0.002, P <0.001 for interaction between time and CFR) and CABG groups (1.28 [IQR: 1.13-1.80] vs. 1.86 [IQR: 1.57-2.22], P <0.001). The reduction in SYNTAX or Leaman scores after PCI or CABG was independently associated with the percent increase in CFR after adjusting for baseline characteristics (P=0.012 and P=0.011, respectively).
Conclusion(s): Coronary revascularisation ameliorated reduced CFR in patients with obstructive CAD. The degree of improvement in angiographic CAD burden by revascularisation was correlated with magnitude of improvement in CFR.
Methods and Results: In a prospective, multicentre observational study, CFR was measured by 15O-water positron emission tomography as the ratio of stress to rest myocardial blood flow at baseline and 6 months after optimal medical therapy (OMT) alone, PCI, or CABG. Changes in the SYNTAX and Leaman scores were angiographically evaluated as indicators of completeness of revascularisation. Follow-up was completed by 75 (25 OMT alone, 28 PCI, and 22 CABG) out of 82 patients. The median SYNTAX and Leaman scores, and baseline CFR were 14.5 (interquartile range [IQR]: 8-24.5), 5.5 (IQR: 2.5-12.5), and 1.94 (IQR: 1.67-2.66), respectively. Baseline CFR was negatively correlated with the SYNTAX (ρ = -0.40, P <0.001) and Leaman scores (ρ = -0.33, P=0.004). Overall, only CABG was associated with a significant increase in CFR (1.67 [IQR: 1.14-1.96] vs. 1.98 [IQR: 1.60-2.39], P <0.001). Among patients with CFR<2.0 (n=41), CFR significantly increased in the PCI (1.70 [IQR: 1.42-1.79] vs. 2.21 [IQR: 1.78-2.49], P=0.002, P <0.001 for interaction between time and CFR) and CABG groups (1.28 [IQR: 1.13-1.80] vs. 1.86 [IQR: 1.57-2.22], P <0.001). The reduction in SYNTAX or Leaman scores after PCI or CABG was independently associated with the percent increase in CFR after adjusting for baseline characteristics (P=0.012 and P=0.011, respectively).
Conclusion(s): Coronary revascularisation ameliorated reduced CFR in patients with obstructive CAD. The degree of improvement in angiographic CAD burden by revascularisation was correlated with magnitude of improvement in CFR.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
Perioperative echocardiographic strain analysis: what anesthesiologists should know.Canadian Journal of Anaesthesia 2024 April 11
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app