The Valuation Of Fractional Flow Reserve In Percutaneous Coronary Intervention Treatment And Its Curative Effect

Objective:To analyze the correlations between FFR and the degree of stenosis and lesionlength(LL) in patients with the diagnosis of coronary atherosclerotic heart disease, and toevaluate FFR in coronary revascularization treatment.Methods:Forty-three patients with the diagnosis of coronary atherosclerotic heart disease andhospitalized in the department of cardiology of the Number One People’s Hospital ofZhangjiagang City from february2012to july2013were included. The age of the patientswas48～81years old, and the mean age was （64.85±8.18） years.3ml of blood sampleswere obtained on an empty stomach in the second morning of hospitalization. Low-densitylipoprotein-cholesterol (LDL-C), total cholesterol(TC), triglyceride(TG) and bloodglucose(GLU) were measured. All the patients then underwent coronary angiography andFFR. LDL-C,TC,TG,GLU, the degree of stenosis,lesion length(LL) and whether calciumwas shown were also compared between patients with FFR≥0.8and those with FFR＜0.8,and the correlations between FFR and the degree of stenosis and LL were studied.Stenting would be carried on only if the FFR was＜0.80. We compared FFR before andafter stenting, and FFR after stenting in FFR＜0.8group and in FFR≥0.8group. Thenumber of readmissions for cardiac causes, a new episode of angina，revascularization ofthe target lesion, arrhythmia, heart failure， and acute myocardial infarction wererecorded and compared between the two groups in the first year of the study.Results:1. There was no differences of LDL-C,TC,TG and GLU between FFR≥0.8groupand FFR＜0.8group.2. In FFR≥0.8group, the degree of stenosis and LL were（62.1±7.8）%and（13.3±4.9）mm,and in FFR＜0.8group, the degree of stenosis and LL were （71.0±2.2）% and（26.2±2.2）mm. There were significant differences of the degree of stenosis and LLbetween the two groups （P=0.01and P＜0.001,respectivly）. Significant negativecorrelations between FFR and the degree of stenosis (r=-0.591， P＜0.001) andLL(r=-0.694， P＜0.001)had been found either.3. In patients with FFR＜0.8,FFR was0.702±0.096before stenting, and was0.926±0.015after stenting. FFR was very different before and after stenting(P=0.041).There was no differences of FFR between patients accept stenting in FFR＜0.8group andthose in FFR≥0.8group(FFR=0.895±0.049)（P=0.123）.4. During one-year follow up, there were3readmissions for cause ofrevascularization of the target lesion with a new episode of angina, arrhythmia and heartfailure in FFR≥0.8group, and there were no readmissions for the causes above in FFR＜0.8group. But there were no differences of the rate of revascularization of the target lesionwith a new episode of angina, arrhythmia and heart failure between the two groups(P=0.902of all). There was no acute myocardial infarction event at1year in both of twogroups.Conclusion:1. There were significant negative correlations between FFR and the degree ofstenosis and LL. It demonstrated that the more severity of the degree of stenosis and thelonger of LL, the more significant of the functional repercussion of coronary would beshown.2. FFR measurement was useful in guiding PCI treatment and in evaluating stenting,and can reduce the rate of MACE(major adverse cardiac event).