NEJM:血管重建术中IFR与FFR的比较

2017-05-11 zhangfan MedSci原创

稳定型心绞痛或急性冠脉综合征患者,IFR引导重建策略与FFR引导重建策略在12个月主要心脏不良事件发生率方面无显著差异

瞬时无波率(IFR)是一种用于评估冠状动脉狭窄严重程度的指标。小规模试验表明瞬时无波率(IFR)与血流储备分数(FFR)有类似的诊断准确性。但IFR的使用缺乏相应的临床研究。近日研究人员比较了IFR与FFR两种方法血管重建后主要心脏不良事件的发生率。

研究招募了2037名稳定型心绞痛或急性冠脉综合征、需要冠状动脉狭窄的生理指导评估患者,随机分配接受IFR或FFR血管重建指导。研究的主要终点是术后12个月内任何原因死亡、非致死性心肌梗死或计划外血管重建的复合发生率。

研究发现,1012名IFR组患者有68名(6.7%)发生主要终点,1007名FFR组患者中,有61名发生(6.1%)主要终点(事件发生率差异,0.7%;95%  [CI],-1.5-2.8;P = 0.007的非劣效性;风险比,1.12;95% CI,0.79-1.58;P = 0.53)。主要亚组间的结果相似。两组患者心肌梗死、靶病变血管重建、再狭窄、支架血栓形成率的差异无统计学意义。研究中FFR组患者发生胸部不适的比例较高。

研究认为,对于稳定型心绞痛或急性冠脉综合征患者,IFR引导重建策略与FFR引导重建策略在12个月主要心脏不良事件发生率方面无显著差异,两种方法效果相近。

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    2018-03-12 huangshifeng
  2. [GetPortalCommentsPageByObjectIdResponse(id=2036493, encodeId=f4f22036493ee, content=<a href='/topic/show?id=20059469f6' target=_blank style='color:#2F92EE;'>#IFR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9469, encryptionId=20059469f6, topicName=IFR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b30d401, createdName=huangshifeng, createdTime=Mon Mar 12 02:26:00 CST 2018, time=2018-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196864, encodeId=05501968649c, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Fri May 12 06:42:07 CST 2017, time=2017-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196620, encodeId=b73c19662080, content=学习了,感谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Thu May 11 12:17:00 CST 2017, time=2017-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196603, encodeId=5d0b196603f1, content=学习过了,值得分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160914/IMG57D82E721DB581755.jpg, createdBy=4fc81933929, createdName=明天会更好!, createdTime=Thu May 11 11:30:34 CST 2017, time=2017-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196566, encodeId=209f1965667a, content=瞬时无波率(IFR)是一种用于评估冠状动脉狭窄严重程度的指标, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170207/IMG589913E36908D4741.jpg, createdBy=99331680071, createdName=knowheart, createdTime=Thu May 11 09:34:33 CST 2017, time=2017-05-11, status=1, ipAttribution=)]
    2017-05-12 龙胆草

    学习了,谢谢分享

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=2036493, encodeId=f4f22036493ee, content=<a href='/topic/show?id=20059469f6' target=_blank style='color:#2F92EE;'>#IFR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9469, encryptionId=20059469f6, topicName=IFR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b30d401, createdName=huangshifeng, createdTime=Mon Mar 12 02:26:00 CST 2018, time=2018-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196864, encodeId=05501968649c, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Fri May 12 06:42:07 CST 2017, time=2017-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196620, encodeId=b73c19662080, content=学习了,感谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Thu May 11 12:17:00 CST 2017, time=2017-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196603, encodeId=5d0b196603f1, content=学习过了,值得分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160914/IMG57D82E721DB581755.jpg, createdBy=4fc81933929, createdName=明天会更好!, createdTime=Thu May 11 11:30:34 CST 2017, time=2017-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196566, encodeId=209f1965667a, content=瞬时无波率(IFR)是一种用于评估冠状动脉狭窄严重程度的指标, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170207/IMG589913E36908D4741.jpg, createdBy=99331680071, createdName=knowheart, createdTime=Thu May 11 09:34:33 CST 2017, time=2017-05-11, status=1, ipAttribution=)]
    2017-05-11 1e0f8808m18(暂无匿称)

    学习了,感谢分享。

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2036493, encodeId=f4f22036493ee, content=<a href='/topic/show?id=20059469f6' target=_blank style='color:#2F92EE;'>#IFR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9469, encryptionId=20059469f6, topicName=IFR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b30d401, createdName=huangshifeng, createdTime=Mon Mar 12 02:26:00 CST 2018, time=2018-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196864, encodeId=05501968649c, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Fri May 12 06:42:07 CST 2017, time=2017-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196620, encodeId=b73c19662080, content=学习了,感谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Thu May 11 12:17:00 CST 2017, time=2017-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196603, encodeId=5d0b196603f1, content=学习过了,值得分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160914/IMG57D82E721DB581755.jpg, createdBy=4fc81933929, createdName=明天会更好!, createdTime=Thu May 11 11:30:34 CST 2017, time=2017-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196566, encodeId=209f1965667a, content=瞬时无波率(IFR)是一种用于评估冠状动脉狭窄严重程度的指标, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170207/IMG589913E36908D4741.jpg, createdBy=99331680071, createdName=knowheart, createdTime=Thu May 11 09:34:33 CST 2017, time=2017-05-11, status=1, ipAttribution=)]
    2017-05-11 明天会更好!

    学习过了,值得分享!

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2036493, encodeId=f4f22036493ee, content=<a href='/topic/show?id=20059469f6' target=_blank style='color:#2F92EE;'>#IFR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9469, encryptionId=20059469f6, topicName=IFR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b30d401, createdName=huangshifeng, createdTime=Mon Mar 12 02:26:00 CST 2018, time=2018-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196864, encodeId=05501968649c, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Fri May 12 06:42:07 CST 2017, time=2017-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196620, encodeId=b73c19662080, content=学习了,感谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Thu May 11 12:17:00 CST 2017, time=2017-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196603, encodeId=5d0b196603f1, content=学习过了,值得分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160914/IMG57D82E721DB581755.jpg, createdBy=4fc81933929, createdName=明天会更好!, createdTime=Thu May 11 11:30:34 CST 2017, time=2017-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196566, encodeId=209f1965667a, content=瞬时无波率(IFR)是一种用于评估冠状动脉狭窄严重程度的指标, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170207/IMG589913E36908D4741.jpg, createdBy=99331680071, createdName=knowheart, createdTime=Thu May 11 09:34:33 CST 2017, time=2017-05-11, status=1, ipAttribution=)]
    2017-05-11 knowheart

    瞬时无波率(IFR)是一种用于评估冠状动脉狭窄严重程度的指标

    0

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