The Prognostic Analysis Of Patients With Coronary Artery Disease Based On Fractional Flow Reserve

Objective:To investigate the risk factors influencing FFR and the long-term prognosis of medical therapy in patients with FFR>0.80.Methods: From January 2017 to November 2021,we enrolled 562 patients with CAD underwent FFR at the First Affiliated Hospital of Xinjiang Medical University.They were divided into FFR≤0.80 group and FFR>0.80 group.We analyze the risk factors of FFR≤0.80 by logistic multivariate regression.In addition,according to the different treatment methods of patients during hospitalization,the FFR≤0.80 group was further divided into PCI group and the medical therapy group,and FFR>0.80 group all received medical therapy.Patients were followed up the occurrence of major adverse cardiovascular and cerebrovascular events(MACCEs)after discharge.The Kaplan-Meier method was used to plot the survival curves of patients with MACCEs and unplanned revascularization.Multivariate Cox regression was used to analyze the independent risk factors of long-term prognosis after medical therapy in the FFR>0.80 group.Results: Logistic multivariate regression analysis showed diabetes mellitus [OR 1.75,95%CI(1.16-2.63),P=0.008],coronary stenosis [OR 1.14,95%CI(1.10-1.18),P<0.001],diffuse lesion[OR 1.92,95%CI(1.25-2.93),P=0.003] were risk factors in the FFR≤0.80 group.Survival analysis showed that after 5.5 years of follow-up,the risk of MACCEs and unplanned revascularization in the FFR≤0.80 medical therapy group were significantly higher than those in the other two groups(P<0.05).Multivariate Cox regression analysis showed that diabetes mellitus [HR 3.48,95%CI(1.38-8.75),P=0.008] and in-stent restenosis [HR 4.79,95%CI(1.64-13.98),P=0.004]independently predicted the occurrence of MACCEs in patients with FFR>0.80.Conclusion: Diabetes mellitus,coronary stenosis and diffuse lesions are risk factors in the FFR≤0.80 group.PCI treatment can significantly improve the prognosis of patients with FFR≤0.80.Diabetes mellitus and in-stent restenosis are independent predictors of long-term adverse events after medical therapy in patients with FFR>0.80 group.