Page 103 - Coronary hemodynamics in acute myocardial infarction - Matthijs Bax

Coronary autoregulation and fatal events in stable CAD
or by fractional flow reserve or hyperemic stenosis resistance index were similar between groups. Accordingly, percutaneous coronary intervention of the lesion of interest was performed equivalently between groups. Nevertheless, CFVR in the target vessel was significantly lower among patients with an impaired reference vessel CFVR.
Table 1. Clinical and Procedural Characteristics of Study Population, and Stratified According to Patients with a Normal or Abnormal Reference Vessel CFVR (n=178)
No. of patients Age, y
Male Sex
Risk Factors
Hypertension
Hyperlipidemia
Family History of CAD
Smoking
Diabetes Mellitus
Prior Myocardial Infarction
Prior percutaneous coronary intervention
Medication at hospital admission
B-Blocker
Calcium antagonist ACE Inhibitor Nitrates Lipid-lowering drugs Aspirin
Ventricular Function
Abnormal left ventricular function (EF <50%)
Left ventricular hypertrophy
Hemodynamics during measurements
Baseline
Heart rate, bpm
Mean arterial pressure, mmHg
Hyperemia
Heart rate, bpm
Mean arterial pressure, mmHg
Functional parameters prior to PCI/deferral
Two-vessel coronary artery disease Diameter stenosis most severe lesion (%) Reversible ischemia on MPS
CFVR target vessel
All
178 59±13 128 (72)
70 (39) 102 (57) 86 (48) 61 (34) 27 (15) 65 (37) 25 (14)
141 (79) 112 (63) 34 (19) 120 (67) 102 (57) 159 (89)
14 (8) 9 (5)
68±11 98±13
68±11 94±13
123 (69) 57±10 61 (34) 2.2±0.8
Reference CFVR
Normal Abnormal
>2.7 ≤ 2.7
101 77 57±9 61±16 77 (76) 51 (66)
38 (37) 32 (42) 67 (66) 35 (45) 50 (50) 36 (47) 36 (36) 25 (32) 14 (14) 13 (17) 36 (36) 29 (38) 14 (14) 11 (14)
80 (79) 61 (79) 65 (64) 47 (61) 20 (20) 14 (18) 66 (65) 54 (70) 62 (61) 40 (52) 92 (91) 67 (87)
5 (5) 9 (12) 4 (4) 5 (6)
67±11 69±10 96±11 101±14
67±11 70±10 93±11 97±14
69 (68) 54 (70) 57±10 57±11 37 (37) 24 (31) 2.4±0.8 1.9±0.6
P value*
0.04 0.18
0.64
0.01
0.76
0.75 6 0.68
0.88 1.0
1.00 0.75 0.85 0.52 0.22 0.47
0.16 0.73
0.24 0.03
0.14 0.06
0.80 0.74 0.52 <0.001
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