Clinical Value of the Quantitative Flow Ratio to Predict Long-term Target Vessel Failure in Patients with In-stent Restenosis after Drug-coated Balloon Angioplasty

作     者：Xiang-qi WU Long-bo LI Wei YOU Zhi-ming WU Lei ZHAO Zhi-hui WANG Pei-na MENG Bin LIU Fei YE Xiang-qi WU;Long-bo LI;Wei YOU;Zhi-ming WU;Lei ZHAO;Zhi-hui WANG;Pei-na MENG;Bin LIU;Fei YE

作者机构：Department of CardiologyNanjing First HospitalNanjing Medical UniversityNanjing210006China Department of CardiologyThe Second Hospital of Jilin UniversityJilin130000China 

出 版 物：《Current Medical Science》 (当代医学科学（英文）)

年 卷 期：2024年第44卷第3期

页      面：561-567页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：supported by the Nanjing Municipal Science and Technology Bureau(No.201803008) the Cardiocare Sponsored Optimized Antithrombotic Research Fund(No.BJUHFCSOARF201801-13) 

主　　题：percutaneous coronary intervention in-stent restenosis target vessel failure quantitative flow ratio 

摘      要：Objective The study sought to investigate the clinical predictive value of quantitative flow ratio(QFR)for the long-term target vessel failure(TVF)outcome in patients with in-stent restenosis(ISR)by using drug-coated balloon(DCB)treatment after a long-term *** This was a retrospective study.A total of 186 patients who underwent DCB angioplasty for ISR in two hospitals from March 2014 to September 2019 were *** QFR of the entire target vessel was measured *** primary endpoint was TVF,including target vessel-cardiac death(TV-CD),target vessel-myocardial infarction(TV-MI),and clinically driven-target vessel revascularization(CD-TVR).Results The follow-up time was 3.09±1.53 years,and 50 patients had *** QFR immediately after percutaneous coronary intervention(PCI)was significantly lower in the TVF group than in the no-TVF *** Cox regression analysis indicated that the QFR immediately after PCI was an excellent predictor for TVF after the long-term follow-up[hazard ratio(HR):5.15×10−5(6.13×10−8−0.043);P0.01].Receiver-operating characteristic(ROC)curve analysis demonstrated that the optimal cut-off value of the QFR immediately after PCI for predicting the long-term TVF was 0.925(area under the curve:0.886,95%confidence interval:0.834–0.938;sensitivity:83.40%,specificity:88.00;P0.01).In addition,QFR≤0.925 post-PCI was strongly correlated with the TVF,including TV-MI and CD-TVR(P0.01).Conclusion The QFR immediately after PCI showed a high predictive value of TVF after a long-term follow-up in ISR patients who underwent DCB angioplasty.A lower QFR immediately after PCI was associated with a worse TVF outcome.