The Significance Of CFR In Critical Coronary Artery Disease

ObjectiveContinuously selected for admission to the TEDA International Cardiovascular Hospital for simultaneous coronary angiography(CAG)examinations and Positron Emission Tomography/Computed Tomography(PET/CT)examinations.By studying the clinical baseline data,laboratory test indexes,CAG results,and total coronary flow reserve(CFR)results of these patients,we investigated the causes of critical coronary artery disease and coronary microvascular disease(Coronary microvascular disease,CMVD)risk factors,and based on the results of follow-up,explore the significance of CFR in guiding the treatment of CMVD and determining prognosis.MethodsPatients who underwent coronary angiography during the period from October 2017 to January 2018 at TEDA International Cardiovascular Hospital for coronary angiography showed that they had consecutive coronary angiograms that indicated critical coronary artery disease 34 for example,CFR was measured by PET/CT by collecting clinical data,clinical biochemical examinations,and CFR results from the study subjects,and the CFR<2.0 measured by PET/CT was used as the criterion for coronary microvascular disease.To compare the age,sex,diabetes,LDL cholesterol,total cholesterol(TC),triglyceride,high-density lipoprotein levels,family history,ultrasound and history of hyperlipidemia in the coronary microvascular disease group and the uncombined coronary microvascular disease group.Factors such as cardiogram and body mass index(BMI)were used to analyze the risk factors leading to critical coronary artery disease complicated with CMVD.For patients with coronary microvascular disease,in addition to the same anti-platelet and lipid-regulating drugs,they were given Nicorandil treatment,and based on follow-up results,explore CFR for critical coronary arteries Treatment of CMVD combined with lesions and its significance for prognosis.ResultsA total of 34 patients were enrolled,including 16 with CMVD(abnormal)and 18 without CMVD(normal).Comparing clinical baseline data between the two groups of patients,the difference in body mass index(BMI:28± 1.95 vs 23± 1.95)and diabetes mellitus between the CMVD group and the uncombined CMVD group was statistically significant(P<0.05).Comparison of conventional biochemical tests between the two groups showed that the total cholesterol levels(TC:6.72±0.90 vs 5.39±0.92)in the combined CMVD group and non-combined CMVD group were statistically significant(P<0.05).Through univariate Logistic regression analysis,patients with elevated BMI[OR(95%Cl):3.64(1.016-13.066),P=0.047]and elevated cholesterol[OR(95%Cl):7.320(1.027-52.188),P=0.047]is a risk factor for coronary microvascular disease.Although there is a significant difference in the history of diabetes between the CMVD group and the uncombined CMVD group,in this study,the diabetic disease is not a risk factor for critical coronary artery disease with CMVD.For patients in the combined CMVD group(n=16),after using nicorandil,by telephone and outpatient follow-up,the number of patients with chest pain or chest tightness symptoms that can be found in the patient was(n=8),through the receiver operating curve(ROC)The area under the curve(AUC = 0.82)was calculated,the CFR threshold for symptomatic relief was 1.92,the sensitivity was 87%,and the specificity was 81.8%.ConclusionRisk factors for critical coronary artery disease with CMVD include elevated BMI and increased total cholesterol.For patients with critical coronary artery disease and CMVD,patients with a CFR of<1.92,the use of drugs to improve microvascular disease,the relief of chest tightness,chest pain symptoms worse than patients with CFR>1.92.