Clinical and hemodynamic characteristics of patients with intermediate coronary lesions selected for elective percutaneous coronary intervention
The aim – to identify clinical, angiographic and hemodynamic factors, having impact upon the decision on percutaneous coronary intervention (PCI) in stable coronary artery disease (SCAD) patients with intermediate subepicardial coronary lesions, in clinical settings. Materials and methods. The cross...
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TOV Chetverta Khvylia
2023-06-01
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| Series: | Кардіохірургія та інтервенційна кардіологія |
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| Online Access: | https://csic.com.ua/en/issues/archive/1-2-2023/1370-clinical-and-hemodynamic-characteristics-of-patients-with-intermediate-coronary-lesions-selected-for-elective-percutaneous-coronary-intervention.html |
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| author | M.V. Stan К.О. Mikhaliev A.V. Khokhlov O.J. Zharinov B.M. Todurov |
| author_facet | M.V. Stan К.О. Mikhaliev A.V. Khokhlov O.J. Zharinov B.M. Todurov |
| author_sort | M.V. Stan |
| collection | DOAJ |
| description | The aim – to identify clinical, angiographic and hemodynamic factors, having impact upon the decision on percutaneous coronary intervention (PCI) in stable coronary artery disease (SCAD) patients with intermediate subepicardial coronary lesions, in clinical settings. Materials and methods. The cross-sectional single-center study analyzed clinical and instrumental data from 123 SCAD patients (mean age 62 ± 9 years; 90 (73.2 %) males) and intermediate (50–90 %) stenotic subepicardial coronary lesions (by invasive coronary angiography [ICA]). The enrolled sample included 74 (60.2 %) patients with an assessment of ICA-derived fractional flow reserve (FFR). The studied parameters were analyzed in the groups of decision not to perform (PCI(–); n = 30 [24.4 %]) and to perform PCI (PCI(+); n = 93 [75.6 %]). Results. The positive decision on PCI was more frequent in patients with stable angina ІII and ІI CCS class, as compared to those without angina (93 %, 79 % і 46 %, respectively; рtrend < 0.001). PCI was considered to be appropriate in all patients with FFR < 0.8 (46 of 74 (62 %) cases). The more advanced hemodynamic compromise of coronary lesions was associated with the higher maximum degree of coronary artery stenosis. Multivariable logistic regression analysis revealed a more pronounced coronary stenosis (at least, in one subepicardial coronary artery territory) was independently associated with the PCI(+) decision (stenosis 80–90 % vs. 70–79 %; 70–79 % vs. 60–69 %; 60–69 % vs. 50–59 %: odds ratio 26 (95 % confidence interval 8–87); р < 0.001). Conclusions. A degree of coronary artery stenosis was a key factor impacting upon a positive decision on PCI in SCAD patients with intermediate (50–90 %) coronary lesions. There is a need for the broader implementation of non-invasive diagnostic tests and the tools for a quantitative assessment of myocardial ischemia in patients with intermediate pretest probability of coronary stenosis, including those with previous PCI.
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| format | Article |
| id | doaj-art-0e367feb504640529ed496b094730669 |
| institution | Kabale University |
| issn | 2305-3127 |
| language | English |
| publishDate | 2023-06-01 |
| publisher | TOV Chetverta Khvylia |
| record_format | Article |
| series | Кардіохірургія та інтервенційна кардіологія |
| spelling | doaj-art-0e367feb504640529ed496b0947306692025-01-16T15:52:52ZengTOV Chetverta KhvyliaКардіохірургія та інтервенційна кардіологія2305-31272023-06-011/2294010.31928/2305-3127-2023.1-2.2940Clinical and hemodynamic characteristics of patients with intermediate coronary lesions selected for elective percutaneous coronary interventionM.V. Stan0К.О. Mikhaliev1A.V. Khokhlov2O.J. Zharinov3https://orcid.org/0000-0002-4089-9757B.M. Todurov4Shupyk National Healthcare University of Ukraine, Kyiv, UkraineState Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administrative Department, Kyiv, Ukraine Heart Institute of the Ministry of Health of Ukraine, Kyiv, UkraineShupyk National Healthcare University of Ukraine, Kyiv, UkraineHeart Institute of the Ministry of Health of Ukraine, Kyiv, UkraineThe aim – to identify clinical, angiographic and hemodynamic factors, having impact upon the decision on percutaneous coronary intervention (PCI) in stable coronary artery disease (SCAD) patients with intermediate subepicardial coronary lesions, in clinical settings. Materials and methods. The cross-sectional single-center study analyzed clinical and instrumental data from 123 SCAD patients (mean age 62 ± 9 years; 90 (73.2 %) males) and intermediate (50–90 %) stenotic subepicardial coronary lesions (by invasive coronary angiography [ICA]). The enrolled sample included 74 (60.2 %) patients with an assessment of ICA-derived fractional flow reserve (FFR). The studied parameters were analyzed in the groups of decision not to perform (PCI(–); n = 30 [24.4 %]) and to perform PCI (PCI(+); n = 93 [75.6 %]). Results. The positive decision on PCI was more frequent in patients with stable angina ІII and ІI CCS class, as compared to those without angina (93 %, 79 % і 46 %, respectively; рtrend < 0.001). PCI was considered to be appropriate in all patients with FFR < 0.8 (46 of 74 (62 %) cases). The more advanced hemodynamic compromise of coronary lesions was associated with the higher maximum degree of coronary artery stenosis. Multivariable logistic regression analysis revealed a more pronounced coronary stenosis (at least, in one subepicardial coronary artery territory) was independently associated with the PCI(+) decision (stenosis 80–90 % vs. 70–79 %; 70–79 % vs. 60–69 %; 60–69 % vs. 50–59 %: odds ratio 26 (95 % confidence interval 8–87); р < 0.001). Conclusions. A degree of coronary artery stenosis was a key factor impacting upon a positive decision on PCI in SCAD patients with intermediate (50–90 %) coronary lesions. There is a need for the broader implementation of non-invasive diagnostic tests and the tools for a quantitative assessment of myocardial ischemia in patients with intermediate pretest probability of coronary stenosis, including those with previous PCI. https://csic.com.ua/en/issues/archive/1-2-2023/1370-clinical-and-hemodynamic-characteristics-of-patients-with-intermediate-coronary-lesions-selected-for-elective-percutaneous-coronary-intervention.htmlcoronary artery diseasemyocardial revascularizationcoronary angiographyfractional flow reserve |
| spellingShingle | M.V. Stan К.О. Mikhaliev A.V. Khokhlov O.J. Zharinov B.M. Todurov Clinical and hemodynamic characteristics of patients with intermediate coronary lesions selected for elective percutaneous coronary intervention Кардіохірургія та інтервенційна кардіологія coronary artery disease myocardial revascularization coronary angiography fractional flow reserve |
| title | Clinical and hemodynamic characteristics of patients with intermediate coronary lesions selected for elective percutaneous coronary intervention |
| title_full | Clinical and hemodynamic characteristics of patients with intermediate coronary lesions selected for elective percutaneous coronary intervention |
| title_fullStr | Clinical and hemodynamic characteristics of patients with intermediate coronary lesions selected for elective percutaneous coronary intervention |
| title_full_unstemmed | Clinical and hemodynamic characteristics of patients with intermediate coronary lesions selected for elective percutaneous coronary intervention |
| title_short | Clinical and hemodynamic characteristics of patients with intermediate coronary lesions selected for elective percutaneous coronary intervention |
| title_sort | clinical and hemodynamic characteristics of patients with intermediate coronary lesions selected for elective percutaneous coronary intervention |
| topic | coronary artery disease myocardial revascularization coronary angiography fractional flow reserve |
| url | https://csic.com.ua/en/issues/archive/1-2-2023/1370-clinical-and-hemodynamic-characteristics-of-patients-with-intermediate-coronary-lesions-selected-for-elective-percutaneous-coronary-intervention.html |
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