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Predictors of vessel quantitative flow ratio loss in patients with severely calcified lesions after rotational atherectomy
Affiliations- Division of Cardiology, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui Province, China
- Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
- Division of Cardiology, Nanjing Jinling Hospital, Nanjing, China
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Abstract
Background: Previous studies have established that moderately to severely calcified lesions (MSCL)
are associated with high rates of major adverse cardiovascular events, even when drug-eluting stents
are implanted after rotational atherectomy (RA). Yet, the changes in coronary function indexes during
follow-ups have never been investigated. The quantitative flow ratio (QFR), a novel coronary function
index, has been increasingly adopted in daily practice in recent years.
Methods: A total of 111 MSCL patients were retrospectively enrolled in this study. The vessel QFR
(QFRv) loss was defined as post-percutaneous coronary intervention QFRv minus follow-up QFRv. The
study subjects were divided into high QFRv loss (n = 51) and low QFRv loss (n = 60) groups according
to the binary method. The obtained predictors of QFRv loss were then analyzed.
Results: The results showed that the final burr-to-vessel ratio (B to V ratio) in the high QFRv loss
group decreased significantly compared to the low QFRv loss group (p < 0.01). The univariate and
multivariate regression analyses indicated that the final B to V ratio was an excellent predictor of QFRv
loss. The cut-off value of the final B to V ratio for QFRv loss prediction was 0.50 (sensitivity: 50.98%,
specificity: 68.33%, and area under the curve: 0.627 [95% confidence interval: 0.530–0.717], p < 0.05).
Additionally, the target vessel failure incidence in the high QFRv loss group was higher than in the low
QFRv loss group (p < 0.01).
Conclusions: An increased burr-to-vessel ratio can prevent QFRv loss in patients with MSCLs after
RA, an effect that might be closely associated with a low target vessel failure incidence.
Abstract
Background: Previous studies have established that moderately to severely calcified lesions (MSCL)
are associated with high rates of major adverse cardiovascular events, even when drug-eluting stents
are implanted after rotational atherectomy (RA). Yet, the changes in coronary function indexes during
follow-ups have never been investigated. The quantitative flow ratio (QFR), a novel coronary function
index, has been increasingly adopted in daily practice in recent years.
Methods: A total of 111 MSCL patients were retrospectively enrolled in this study. The vessel QFR
(QFRv) loss was defined as post-percutaneous coronary intervention QFRv minus follow-up QFRv. The
study subjects were divided into high QFRv loss (n = 51) and low QFRv loss (n = 60) groups according
to the binary method. The obtained predictors of QFRv loss were then analyzed.
Results: The results showed that the final burr-to-vessel ratio (B to V ratio) in the high QFRv loss
group decreased significantly compared to the low QFRv loss group (p < 0.01). The univariate and
multivariate regression analyses indicated that the final B to V ratio was an excellent predictor of QFRv
loss. The cut-off value of the final B to V ratio for QFRv loss prediction was 0.50 (sensitivity: 50.98%,
specificity: 68.33%, and area under the curve: 0.627 [95% confidence interval: 0.530–0.717], p < 0.05).
Additionally, the target vessel failure incidence in the high QFRv loss group was higher than in the low
QFRv loss group (p < 0.01).
Conclusions: An increased burr-to-vessel ratio can prevent QFRv loss in patients with MSCLs after
RA, an effect that might be closely associated with a low target vessel failure incidence.
Keywords
percutaneous coronary intervention, rotational atherectomy, calcification, quantitative flow ratio
About this articleTitle
Predictors of vessel quantitative flow ratio loss in patients with severely calcified lesions after rotational atherectomy
Journal
Issue
Article type
Original Article
Pages
353-360
Published online
2022-10-04
Page views
1776
Article views/downloads
386
DOI
Pubmed
Bibliographic record
Cardiol J 2023;30(3):353-360.
Keywords
percutaneous coronary intervention
rotational atherectomy
calcification
quantitative flow ratio
Authors
Yu-he Zhou
Hai-mei Xu
Ying-ying Zhao
Jing-dong Zhu
Yu Xu
Hai-hua Xu
Yan-qing Wang
Ze-ping Hu
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