A Clinical Application Analysis Of Coronary Angiography Versus FFR For Guiding Percutaneous Coronary Intervention With Coronary Artery Disease

Object： To explore the clinical application of coronary angiography versus FFR for guidingpercutaneous coronary intervention with coronary artery disease.Methods： We used coronary angiography to select82patients (147lesions) of the coronary heartdisease patients in accordance with the principle completely random from cardiovascular medicine in ourhospital from July2012to January2013, more than three high qualification intervention physiciansassessed lesions in patients with moderate stenosis between70%-90%. We believed a valid vesseldiameter should being greater than2.5mm vessel, then they were randomly divided into the experimentalgroup and control group.. The patients in FFR group was40(72lesions) combined with FFR measurementin each diseased coronary artery,and drug-eluting stents(DES) were placed in indicated lesions only if theFFR was0.80or less. We measured the FFR values of treatment of disease after surgery, We usedhigh-pressure balloon inflation to expansed stenosis again for FFR≤0.80, and we must be sure that alllesions after treatment FFR>0.80finally.The patients in control group was42(75lesions) underwent DESimplantation in all lessions guided by coronary angiography alone as controls. All treatment of coronaryartery disease were followed to the coronary interventional treatment guidelines. Missions werestrengthened after surgery in the patients such as coronary heart disease education, risk factors control andregular follow-up. Compared the risk factors in patients with general experimental and controlgroups(Hypertension, diabetes, hyperlipidemia, smoking, age, gender, etc.). Calculated and compared thenumber of lesions, the number of stents implanted, spending during hospitalization,the incidence of majoradverse events (MACE) and cardiovascular angina recurrence rate in both groups of the patients during sixmonthes after the operation.Results: We calculate the general conditions and risk factors such as baseline data statistics aftersurgery between two groups. Patients in both groups showed no differences in gender, age, smokinghistory, history of diabetes, hypertension, serum cholesterol, serum lipoproteins height, serum low-densitylipoprotein, and other vascular lesions in the number of areas, P>0.05. The number of stents used perpatient and the cost in hospital were significantly different between the two groups（0.9±0.9vs1.8±0.8）P<0.05,(47233.5±22962.1vs59969.9±24138.2) P=0.017<0.05. Experimental group and the control groupdid not appear all-cause mortality of the coronary artery disease during6months after the surgery.Meanwhile the recurrent myocardial infarction rate, the rate of repeat revascularization and recurrentangina showed no significant difference between two groups, such as （2.50%vs0.00%），（2.50%vs2.38%），（5.00%vs7.14%,0），P>0.05.Conclusion：1.We applied pressure wire on the same number and similar pathological to measure the changes of myocardial blood flow reserve, the result showed us to reduce the number of stent and avoidthe stent thrombosis occurred again2.The application of fraction flow reserve decreased hospitalizationcost and the economic burden of the patients’ families, it is very good for the current health care policy.3.We contrast angina recurrence and the incidence of MACE during6months after operation, we found itwas no difference between experimental group and control group, It showed us the FFR to measure themyocardial ischemic vascular and direct the treatment of coronary heart disease safe and effective.