Impact of type 2 diabetes mellitus and glucose control on fractional flow reserve measurements in intermediate grade coronary lesions
详细信息    查看全文
  • 作者:Sebastian Reith (1)
    Simone Battermann (1)
    Martin Hellmich (2)
    Nikolaus Marx (1)
    Mathias Burgmaier (1)
  • 关键词:Quantitative coronary angiography ; Fractional flow reserve ; Type 2 diabetes mellitus ; Glucose control ; Lesion length
  • 刊名:Clinical Research in Cardiology
  • 出版年:2014
  • 出版时间:March 2014
  • 年:2014
  • 卷:103
  • 期:3
  • 页码:191-201
  • 全文大小:389 KB
  • 参考文献:1. Tobis J, Azarbal B, Slavin L (2007) Assessment of intermediate severity coronary lesions in the catheterization laboratory. J Am Coll Cardiol 49(8):839-48 CrossRef
    2. Pijls NH et al (1996) Measurement of fractional flow reserve to assess the functional severity of coronary-artery stenoses. N Engl J Med 334(26):1703-708 CrossRef
    3. Kang SJ et al (2012) Usefulness of minimal luminal coronary area determined by intravascular ultrasound to predict functional significance in stable and unstable angina pectoris. Am J Cardiol 109(7):947-53 CrossRef
    4. Briguori C et al (2001) Intravascular ultrasound criteria for the assessment of the functional significance of intermediate coronary artery stenoses and comparison with fractional flow reserve. Am J Cardiol 87(2):136-41 CrossRef
    5. Gonzalo N et al (2012) Morphometric assessment of coronary stenosis relevance with optical coherence tomography: a comparison with fractional flow reserve and intravascular ultrasound. J Am Coll Cardiol 59(12):1080-089 CrossRef
    6. Reith S et al (2013) Relationship between optical coherence tomography derived intraluminal and intramural criteria and haemodynamic relevance as determined by fractional flow reserve in intermediate coronary stenoses of patients with type 2 diabetes. Heart 99(10):700-07 CrossRef
    7. Iguchi T et al (2013) Impact of lesion length on functional significance in intermediate coronary lesions. Clin Cardiol 36(3):172-77 CrossRef
    8. Jimenez-Quevedo P et al (2005) LDL-cholesterol predicts negative coronary artery remodelling in diabetic patients: an intravascular ultrasound study. Eur Heart J 26(21):2307-312 CrossRef
    9. Nahser PJ Jr et al (1995) Maximal coronary flow reserve and metabolic coronary vasodilation in patients with diabetes mellitus. Circulation 91(3):635-40 CrossRef
    10. Di Carli MF et al (2003) Role of chronic hyperglycemia in the pathogenesis of coronary microvascular dysfunction in diabetes. J Am Coll Cardiol 41(8):1387-393 CrossRef
    11. Jensen CJ et al (2011) Impact of hyperglycemia at admission in patients with acute ST-segment elevation myocardial infarction as assessed by contrast-enhanced MRI. Clin Res Cardiol 100(8):649-59 CrossRef
    12. Sahinarslan A et al (2009) The reliability of fractional flow reserve measurement in patients with diabetes mellitus. Coron Artery Dis 20(5):317-21 CrossRef
    13. Dominguez-Franco AJ et al (2008) Long-term prognosis in diabetic patients in whom revascularization is deferred following fractional flow reserve assessment. Rev Esp Cardiol 61(4):352-59 CrossRef
    14. Yanagisawa H et al (2004) Application of pressure-derived myocardial fractional flow reserve in assessing the functional severity of coronary artery stenosis in patients with diabetes mellitus. Circ J 68(11):993-98 CrossRef
    15. Anderson JL et al (2007) ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-Elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. J Am Coll Cardiol 50(7):e1–e157 CrossRef
    16. Ryden L et al (2013) ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: the task force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD). Eur Heart J 34(39):3035-087 CrossRef
    17. Reiber JH et al (1985) Assessment of short-, medium-, and long-term variations in arterial dimensions from computer-assisted quantitation of coronary cineangiograms. Circulation 71(2):280-88 CrossRef
    18. Tonino PA et al (2009) Fractional flow reserve versus angiography for guiding percutaneous coronary intervention. N Engl J Med 360(3):213-24 CrossRef
    19. Sachs L (1992) Angewandte Statistik Anwendung statistischer Methoden. Springer, Berlin
    20. Swets JA (1988) Measuring the accuracy of diagnostic systems. Science 240(4857):1285-293 CrossRef
    21. DeLong ER, DeLong DM, Clarke-Pearson DL (1988) Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 44(3):837-45 CrossRef
    22. Moses JW et al (2006) Drug-eluting stents in the treatment of intermediate lesions: pooled analysis from four randomized trials. J Am Coll Cardiol 47(11):2164-171 CrossRef
    23. Tentzeris I et al (2011) Long-term outcome after drug-eluting stent implantation in comparison with bare metal stents: a single centre experience. Clin Res Cardiol 100(3):191-00 CrossRef
    24. de Waha A et al (2011) Long-term outcome after sirolimus-eluting stents versus bare metal stents in patients with diabetes mellitus: a patient-level meta-analysis of randomized trials. Clin Res Cardiol 100(7):561-70 CrossRef
    25. Sels JW et al (2011) Fractional flow reserve in unstable angina and non-ST-segment elevation myocardial infarction experience from the FAME (fractional flow reserve versus angiography for multivessel evaluation) study. JACC Cardiovasc Interv 4(11):1183-189 CrossRef
    26. Bishop AH, Samady H (2004) Fractional flow reserve: critical review of an important physiologic adjunct to angiography. Am Heart J 147(5):792-02 CrossRef
    27. De Bruyne B et al (2001) Fractional flow reserve in patients with prior myocardial infarction. Circulation 104(2):157-62 CrossRef
    28. Pilz G et al (2011) Influence of small caliber coronary arteries on the diagnostic accuracy of adenosine stress cardiac magnetic resonance imaging. Clin Res Cardiol 100(3):201-08 CrossRef
    29. Takiuchi S et al (2002) Hypertension attenuates the efficacy of hypoglycemic therapy for preserving coronary flow reserve in patients with type 2 diabetes. Hypertens Res 25(6):893-00 CrossRef
    30. Murtagh B et al (2003) Role of incremental doses of intracoronary adenosine for fractional flow reserve assessment. Am Heart J 146(1):99-05 CrossRef
    31. Casella G et al (2004) Are high doses of intracoronary adenosine an alternative to standard intravenous adenosine for the assessment of fractional flow reserve? Am Heart J 148(4):590-95 CrossRef
    32. De Luca G et al (2011) Effects of increasing doses of intracoronary adenosine on the assessment of fractional flow reserve. JACC Cardiovasc Interv 4(10):1079-084 CrossRef
    33. Bartunek J et al (1995) Quantitative coronary angiography in predicting functional significance of stenoses in an unselected patient cohort. J Am Coll Cardiol 26(2):328-34 CrossRef
    34. Brosh D et al (2005) Effect of lesion length on fractional flow reserve in intermediate coronary lesions. Am Heart J 150(2):338-43 CrossRef
    35. Takayama T, Hodgson JM (2001) Prediction of the physiologic severity of coronary lesions using 3D IVUS: validation by direct coronary pressure measurements. Catheter Cardiovasc Interv 53(1):48-5 CrossRef
    36. Costa MA et al (2008) Impact of stent deployment procedural factors on long-term effectiveness and safety of sirolimus-eluting stents (final results of the multicenter prospective STLLR trial). Am J Cardiol 101(12):1704-711 CrossRef
    37. D’Ascenzo F et al (2012) Incidence and predictors of coronary stent thrombosis: evidence from an international collaborative meta-analysis including 30 studies, 221,066 patients, and 4276 thromboses. Int J Cardiol 167(2):575-84 CrossRef
    38. Taggart DP (2013)The FREEDOM trial: a definitive answer to coronary artery bypass grafting or stents in patients with diabetes and multivessel coronary artery disease. Eur J Cardiothorac Surg
    39. Farkouh ME et al (2012) Strategies for multivessel revascularization in patients with diabetes. N Engl J Med 367(25):2375-384 CrossRef
    40. Corpus RA et al (2004) Optimal glycemic control is associated with a lower rate of target vessel revascularization in treated type II diabetic patients undergoing elective percutaneous coronary intervention. J Am Coll Cardiol 43(1):8-4 CrossRef
    41. Akin I et al (2010) Clinical outcomes in diabetic and non-diabetic patients with drug-eluting stents: results from the first phase of the prospective multicenter German DES.DE registry. Clin Res Cardiol 99(6):393-00 CrossRef
    42. Bundes?rztekammer(B?K), Kassen?rztliche Bundesvereinigung(KBV), and Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften(AWMF), Nationale VersorgungsLeitlinie Therapie des Typ-2-Diabetes -Langfassung. Available from: http://www.versorgungsleitlinien.de/themen/diabetes2/dm2_Therapie, 2013
    43. Farhan S et al (2012) Comparison of HbA1c and oral glucose tolerance test for diagnosis of diabetes in patients with coronary artery disease. Clin Res Cardiol 101(8):625-30 CrossRef
    44. Doerr R et al (2011) Oral glucose tolerance test and HbA(1)c for diagnosis of diabetes in patients undergoing coronary angiography: (corrected) the silent diabetes study. Diabetologia 54(11):2923-930 CrossRef
    45. Bartnik M et al (2004) The prevalence of abnormal glucose regulation in patients with coronary artery disease across Europe. The Euro Heart Survey on diabetes and the heart. Eur Heart J 25(21):1880-890 CrossRef
  • 作者单位:Sebastian Reith (1)
    Simone Battermann (1)
    Martin Hellmich (2)
    Nikolaus Marx (1)
    Mathias Burgmaier (1)

    1. Department of Cardiology, Medical Clinic I, University Hospital of the RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
    2. Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany
  • ISSN:1861-0692
文摘
Background Hemodynamic relevance of intermediate grade coronary stenoses is accurately assessed by fractional flow reserve (FFR) measurements. However, the reliability of FFR in patients with type 2 diabetes mellitus (DM) and inadequate glucose control (IGC) is incompletely explored. This study aimed to investigate the impact of DM and IGC on the relationship between FFR measurements and quantitative coronary angiography (QCA)-derived morphological parameters. Methods We performed FFR and QCA in 266 intermediate grade lesions of 224 patients (113 non-DM and 111 DM) with stable coronary artery disease. Diabetic patients were categorized into groups with adequate (HbA1C <7?%) and inadequate (HbA1c ??%) glucose control. Results Intermediate grade lesions from all-DM versus non-DM patients differed significantly in lesion length (LL) (10.91?±?5.79?mm versus 9.23?±?3.85?mm, p?=?0.005) and hemodynamic relevance (FFR ?.8, 37.7?% versus 24.2?%, p?=?0.018). FFR measurements in non-DM, all-DM and DM-IGC patients correlated significantly with percent diameter stenosis (%DS) [non-DM: r 2?=?0.075 (p?=?0.007); all-DM: r 2?=?0.254 (p?<?0.001), DM-IGC: r 2?=?0.301 (p?<?0.001)] and LL [non-DM: r 2?=?0.356; all-DM: r 2?=?0.580, DM-IGC: r 2?=?0.513 (all p?<?0.001)]. There was a better correlation between FFR and both %DS (p?=?0.022) and LL (p?=?0.011) among all-DM compared to non-DM patients. Receiver-operating curve analysis demonstrated that among all QCA-derived parameters LL had the best diagnostic efficacy to predict FFR ?.8 for non-DM (AUC 0.911, 95?% CI 0.861-.960, best cut-off value 9.22?mm), all-DM (AUC 0.967, 95?% CI 0.942-.991, best cut-off value 9.97?mm) and DM-IGC (AUC 0.960, 95?% CI 0.920-.999, best cut-off value 9.97?mm) patients. Conclusion Our data in intermediate grade lesions suggest that FFR is reliable in DM patients and LL is the best predictor for hemodynamic relevance in patients without and with diabetes, irrespective of the glycemic state.

© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号

地址:北京市海淀区学院路29号 邮编:100083

电话:办公室:(+86 10)66554848;文献借阅、咨询服务、科技查新:66554700