| Objective: This research aims to make myocardial fractional flow reserve of coronary angiography through the determination of critical diseases, which is according to the guidance of coronary artery interventional therapy, to explore the significance of myocardial fractional flow reserve on the critical lesion in the treatment of PCI.Methods: In 2013 January to 2013 December in our hospital 89 patients meet the diagnostic criteria of coronary heart disease, coronary angiography results for the implementation of single vessel lesion and the limitation of lesion vascular stenosis(DS) ranged from 50% to 70%, the patients were randomly divided into PCI group and PCI group delay at. Then the measured value of FFR ≥ 0.75, if not, were randomly divided into two groups, only drug therapy; if FFR<0.75, then according to the above random grouping method, delayed PCI group only received drug therapy, defer PCI operation, and immediate PCI group, is that moment of vascular lesions in PCI treatment. Finally, the patients were divided into three groups: group A: FFR score ≥ 0.75 patients, conservative treatment drugs; group B: FFR<0.75 patients received immediate treatment, PCI; group C: FFR<0.75 patients, delayed PCI operation, the conservative treatment of drug. All enrolled patients received 300 mg/d aspirin at least three days before PCI, then continue used 300 mg/d for one month after PCI and the life-long dosage was 100 mg/d. Clopidogrel Were used 75 mg/d before three days before and post PCI at least 12 months.Be heparinized coronary angiography and intraoperative PCI, the application of low molecular weight heparin anticoagulation after subcutaneous injection, continuous application of at least l0 days. The clinical data of the patients with documented basis, clinical features were compared between three groups of gender, age, diabetes, hypertension, hyperlipidemia, family history of coronary heart disease, cardiac ejection fraction and other basic. After 12 months of follow-up of three groups of patients, adverse cardiovascular events were recorded. SPSS18.0 software was used to do statistical analysis of data. Continuous variables were measured by said, count variables represented by the ratio or percentage, comparing the use of continuous variables between the t test, comparison between categorical variables using chi square test. A result of P<0.05 was considered significant.Results: Three groups of patients with clinical features(age, gender based, diabetes, hypertension, hyperlipidemia, family history of coronary heart disease, cardiac ejection fraction) were no significant statistic difference. The three groups had no significant difference in lesion segment, P >0.05. The diameter stenosis rate(DS): A group 58.61 ± 5.42%, B group 57.09 ± 4.56%, C group 58.37 ± 4.76%. The three groups had no significant difference in the diameter stenosis rate, P>0.05. The Reference diameter(RD) patients in each group): A group 3.12 ± 0.45, B group 3.13 ± 0.42, C group 3.21 ± 0.50. The three groups had no significant difference in the reference vessel diameter, P>0.05. Significantly reduced the incidence of major adverse cardiovascular events in B group compared with C group, with significant difference(8.70% vs. 27.27%, P=0.036), the major adverse cardiovascular events in A group, B group is lower than that at PCI, but no significant statistical difference(4.54% vs. 8.70%, P= 0.670), A group of conservative drug treatment with delay PCI C group, the incidence of major adverse cardiac events compared with significant statistical difference(4.54% vs. 27.27%, P=0.005).Conclusion: 1. Clinical prognosis of FFR≥0.75 coronary borderline lesion patients with conservative medical therapy was similar with that of patients whom FFR<0.75 and PCI was performed; 2. Coronary borderline lesion Patients with FFR<0.75 performed PCI could benefit more than deferred PCI; 3. Fractional flow reserve guided percutaneous coronary intervention of borderline lesion based on FFR<0.75 has clinical significance.
|
PDF Full Text Request