Retrospective Analysis Of The Treatment Of Moderate Coronary Artery Stenosis Under The Guidance Of Fractional Flow Reserve

ObjectiveThis retrospective study aimed to evaluate whether there are differences and advantages between the prognosis and efficacy of coronary artery disease treatment guided by blood flow reserve fraction(FFR)and conventional coronary angiography guided treatment.MethodsRetrospective analysis from January 2018 to September 2019 in the second Department of Cardiology of Shaanxi Provincial People's Hospital coronary angiography(CAG)diagnosis of coronary heart disease(CHD),and angiography showed that the degree of coronary stenosis of 50-75% of patients 98,including 55 patients of simple coronary angiography,FFR guided coronary angiography 43 patients.They were divided into two groups: simple coronary angiography group(CAG + drug therapy only,abbreviated as CAG-drug group)and FFR guided coronary angiography group(FFR guided intervention or drug therapy only,abbreviated as CAG-FFR group).Setting the FFR threshold at 0.8,further grouping the CAG-FFR group,if the measured FFR value of the target vessel is less than or equal to 0.8,performing percutaneous coronary intervention(PCI)and drug therapy(CAG-FFR-PCI group for short,n=17)on the vessel;If FFR>0.8,only drug therapy(CAG-FFR-drug group,n=26)is given.Clinical follow-up was performed for 6 months to observe the differences of major adverse cardiovascular events(MACE)(including cardiogenic death,non-fatal myocardial infarction and revascularization)and angina attacks between groups.ResultsPatients in each group showed no significant differences among factors including age,sex,smoking,hypertension,diabetes,hyperlipidemia,antiplatelet drugs,? receptor blockers,ACEI or ARB ? CCB ? statins,nitrates,etc.(P>0.05).Coronary angiography showed no significant difference between the two groups(P>0.05),too.The number of major adversecardiovascular events(MACE)in CAG-drug group and CAG-FFR group were 6 and 3respectively,with the incidence rates of 10.9% and 7.0% respectively(P<0.05).The number of revascularization cases was 4 and 2 respectively,and the incidence rates were 7.3% and4.7% respectively(P<0.05).The number of patients admitted for acute myocardial infarction were 2 and 1 respectively,and the incidence rates were 3.6% and 2.3% respectively(P>0.05).During the follow-up period,the number of angina pectoris cases occurred at least once was 12 cases and 8 cases respectively,and the incidence rates were 21.8% and 18.6%respectively(P<0.05).In the two subgroups measured by FFR,the incidence of cardiovascular adverse events in CAG-FFR-drug group and CAG-FFR-PCI group was 2cases and 1 case respectively.Re-revascularization occurred in 2 cases and in 0 cases.The number of patients admitted for acute myocardial infarction was 0 and 1 respectively.During the follow-up period,the number of angina pectoris occurred at least once was 5cases and 3 cases respectively.There was no significant difference in patient's general baseline data,coronary angiography results,MACE and angina pectoris between the two groups(P>0.05).Conclusion1.FFR can evaluate myocardial ischemia degree of coronary artery critical lesions and can guide the treatment of diseased vessels.2.Compared with the treatment guided by coronary angiography,the treatment of coronary critical lesions guided by FFR can reduce the incidence of major adverse cardiovascular events and improve the prognosis of patients.