PMID- 33044717
OWN - NLM
STAT- MEDLINE
DCOM- 20210628
LR  - 20210628
IS  - 1875-8312 (Electronic)
IS  - 1569-5794 (Linking)
VI  - 37
IP  - 3
DP  - 2021 Mar
TI  - Clinical implication of QFR in patients with ST-segment elevation myocardial 
      infarction after drug-eluting stent implantation.
PG  - 755-766
LID - 10.1007/s10554-020-02068-0 [doi]
AB  - The feasibility and prognostic value of quantitative flow ratio (QFR) after 
      percutaneous coronary intervention (PCI) in ST-segment elevation myocardial 
      infarction (STEMI) patients have not been assessed. The aim of this study was to 
      investigate the prognostic utility of post-PCI QFR to predict outcomes in STEMI 
      and determine the influence of functional results, in both culprit and nonculprit 
      lesions, after PCI. Patients undergoing PCI of culprit lesions and receiving 
      staged procedures of nonculprit lesions after 7 days were enrolled from 2 centers 
      and underwent post-PCI QFR. The primary outcome was the vessel-oriented composite 
      endpoints (VOCEs), defined as vessel-related cardiovascular death, vessel-related 
      myocardial infarction, and target vessel revascularization. Four hundred fifteen 
      vessels (186 culprit lesions and 219 nonculprit lesions) in 186 patients were 
      analyzed. Measured at staged PCI, the post-PCI QFR of culprit lesions was 
      significantly lower than that of nonculprit lesions (0.92 +/- 0.10 versus 
      0.95 +/- 0.08, p < 0.001). The multivariable model demonstrated that low post-PCI 
      QFR was an independent predictor of 2-year VOCE (20.8% versus 5.7%; hazard ratio 
      2.718; 95% CI 1.347-5.486; p = 0.005). In STEMI patients with a low 
      angiography-derived index of microcirculatory resistance (</= 40U), a good 
      correlation and agreement between post-PCI QFR value of culprit lesions at 
      primary and staged procedures (r = 0.942; mean difference: - 0.0017 [- 0.074 to 
      0.070]) was identified. In conclusion, culprit lesions suffered from suboptimal 
      functional results more frequently compared to nonculprit lesions after PCI in 
      STEMI patients. Low post-PCI QFR was associated with subsequent adverse clinical 
      outcomes. After stenting, culprit lesions may feasibly be assessed through QFR 
      without significant microvascular dysfunction.
FAU - Tang, Jiani
AU  - Tang J
AD  - Department of Cardiology, Tongji Hospital, Tongji University, No. 389, Xincun Rd, 
      Putuo District, Shanghai, 200065, China.
FAU - Chu, Jiapeng
AU  - Chu J
AD  - Department of Cardiology, Tongji Hospital, Tongji University, No. 389, Xincun Rd, 
      Putuo District, Shanghai, 200065, China.
FAU - Hou, Hanjing
AU  - Hou H
AD  - Department of Cardiology, Seventh People's Hospital, Shanghai University of 
      Traditional Chinese Medicine, Shanghai, China.
FAU - Lai, Yan
AU  - Lai Y
AD  - Department of Cardiology, Tongji Hospital, Tongji University, No. 389, Xincun Rd, 
      Putuo District, Shanghai, 200065, China.
FAU - Tu, Shengxian
AU  - Tu S
AD  - Biomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao 
      Tong University, Shanghai, China.
FAU - Chen, Fei
AU  - Chen F
AD  - Department of Cardiology, Tongji Hospital, Tongji University, No. 389, Xincun Rd, 
      Putuo District, Shanghai, 200065, China.
FAU - Yao, Yian
AU  - Yao Y
AD  - Department of Cardiology, Tongji Hospital, Tongji University, No. 389, Xincun Rd, 
      Putuo District, Shanghai, 200065, China.
FAU - Ye, Zi
AU  - Ye Z
AD  - Department of Cardiology, Tongji Hospital, Tongji University, No. 389, Xincun Rd, 
      Putuo District, Shanghai, 200065, China.
FAU - Gao, Yanhua
AU  - Gao Y
AD  - Department of Cardiology, Tongji Hospital, Tongji University, No. 389, Xincun Rd, 
      Putuo District, Shanghai, 200065, China.
FAU - Mao, Yu
AU  - Mao Y
AD  - Department of Cardiology, Tongji Hospital, Tongji University, No. 389, Xincun Rd, 
      Putuo District, Shanghai, 200065, China.
FAU - Zhuang, Shaowei
AU  - Zhuang S
AD  - Department of Cardiology, Seventh People's Hospital, Shanghai University of 
      Traditional Chinese Medicine, Shanghai, China.
FAU - Liu, Xuebo
AU  - Liu X
AUID- ORCID: 0000-0001-9985-8960
AD  - Department of Cardiology, Tongji Hospital, Tongji University, No. 389, Xincun Rd, 
      Putuo District, Shanghai, 200065, China. liuxuebo70@126.com.
LA  - eng
GR  - 81670403/National Natural Science Foundation of China/
GR  - 18411950300/Grant of Shanghai Science and Technology Committee/
GR  - 19XD1403300/Grant of Shanghai Science and Technology Committee/
GR  - 19411963200/Grant of Shanghai Science and Technology Committee/
GR  - 2019LJ10/Shanghai Municipal Health Commission/
PT  - Journal Article
PT  - Multicenter Study
DEP - 20201012
PL  - United States
TA  - Int J Cardiovasc Imaging
JT  - The international journal of cardiovascular imaging
JID - 100969716
SB  - IM
MH  - Aged
MH  - Blood Flow Velocity
MH  - China
MH  - *Coronary Angiography
MH  - Coronary Vessels/*diagnostic imaging/physiopathology
MH  - Databases, Factual
MH  - *Drug-Eluting Stents
MH  - Feasibility Studies
MH  - Female
MH  - *Fractional Flow Reserve, Myocardial
MH  - Humans
MH  - Male
MH  - Microcirculation
MH  - Middle Aged
MH  - Percutaneous Coronary Intervention/adverse effects/*instrumentation/mortality
MH  - Predictive Value of Tests
MH  - Recurrence
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - ST Elevation Myocardial Infarction/diagnostic 
      imaging/mortality/physiopathology/*therapy
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Percutaneous coronary intervention
OT  - Quantitative flow ratio
OT  - ST-segment elevation myocardial infarction
OT  - Vessel-oriented composite endpoint
EDAT- 2020/10/13 06:00
MHDA- 2021/06/29 06:00
CRDT- 2020/10/12 12:13
PHST- 2020/07/17 00:00 [received]
PHST- 2020/10/07 00:00 [accepted]
PHST- 2020/10/13 06:00 [pubmed]
PHST- 2021/06/29 06:00 [medline]
PHST- 2020/10/12 12:13 [entrez]
AID - 10.1007/s10554-020-02068-0 [pii]
AID - 10.1007/s10554-020-02068-0 [doi]
PST - ppublish
SO  - Int J Cardiovasc Imaging. 2021 Mar;37(3):755-766. doi: 
      10.1007/s10554-020-02068-0. Epub 2020 Oct 12.