中国动脉硬化杂志2025，Vol.33Issue(6)：523-530,8.DOI:10.20039/j.cnki.1007-3949.2025.06.009
靶血管预处理后μQFR可预测药物涂层球囊治疗冠状动脉原位病变患者VOCE事件的发生
μQFR after target vessel pretreatment can predict the occurrence of VOCE events in patients with de novo coronary artery disease treated with drug-coated balloon
摘要
Abstract
Aim To investigate the predictive value of the Murray law-based quantitative flow ratio(μQFR)after target vessel pretreatment for vascular-related adverse events in patients with de novo coronary lesions treated with drug-coated balloon.Methods This retrospective study included 223 lesions from 223 patients who underwent drug-coated balloon-only strategy and completed 2-year clinical follow-up.Coronary angiographic images of target vessels pre-procedure,post-balloon and post-procedure were collected,and analyzed using a novel Murray's law-based algorithm.The μQFR analysis of each target vessel included not only the μQFR value of the target vessel,but also the length of the target vessel,the degree of vessel diameter stenosis,the reference lumen diameter,the minimum lumen diameter and blood flow velocity.The primary endpoint was defined as the postoperative vessel-oriented composite endpoint(VOCE).Results During the2-year clinical follow-up period,a total of 25 patients(11.2%)experienced VOCE events.Com-pared with the control group,patients with VOCE events after pretreatment showed a decrease in μQFR(P<0.001).Multivariate Logistic analysis showed that a lower target vessel μQFR after pretreatment(OR=0.931,95%CI:0.894～0.969,P<0.001)was an independent predictor of VOCE events.ROC curve analysis showed that the cut-off value for predicting 2-year VOCE events using preprocessed μQFR was 0.83(95%CI:0.727～0.840),with a sensitivity of 72.7%and a specificity of 84.0%(AUC=0.773,95%CI:0.676～0.870,P<0.001).Survival analysis showed that compared with patients with μQFR>0.83,patients with μQFR≤0.83 had a significantly higher incidence of VOCE events at 1 and 2 years,increasing to 3.909 times(16.9%vs.4.6%,HR=3.909,95%CI:1.539～9.930,P=0.004)and 2.867 times(19.7%vs.7.2%,HR=2.867,95%CI:1.301～6.316,P=0.009).After adjusting for potential con-founds,patients with pretreated μQFR≤0.83 had a 2.567 times in 2-year incidence of VOCE events(HR=2.567,95%CI:1.151～5.727,P=0.021)and a 3.712 times in 1-year incidence of VOCE events(HR=3.712,95%CI:1.478～9.810,P=0.006)compared to patients with good pretreatment.Conclusions For patients with in situ coronary artery disease,a lower μQFR after pretreatment increases the risk of postoperative adverse clinical events.μQFR≤0.83 may be used to evaluate the effectiveness of lesion pretreatment.关键词
定量血流分数/药物涂层球囊/冠状动脉原位病变/截断值Key words
quantitative flow ratio/drug-coated balloon/de novo coronary lesion/cutoff value分类
医药卫生引用本文复制引用
姚月明,尹德录,赵国力,李群星,杨杰,常媛,姜春媛,程琪,刘佳雨,彭献镇..靶血管预处理后μQFR可预测药物涂层球囊治疗冠状动脉原位病变患者VOCE事件的发生[J].中国动脉硬化杂志,2025,33(6):523-530,8.基金项目
江苏省卫生健康委员会2020年度医学科研立项项目(ZDB2020029) （ZDB2020029）
