Key result
Diabetes mellitus independently increased the odds of anatomical-functional discordance in intermediate coronary lesions by twofold (OR 2.053) compared to non-diabetic patients, an effect exacerbated by poor glycemic control.
Why the study?
Data regarding the performance of computational fractional flow reserve in patients with diabetes mellitus remain scarce.
Does diabetes mellitus and poor glycemic control increase anatomical-functional discordance assessed by IVUS and QFR in patients with intermediate coronary lesions?
Observational (n=330)
No
Does diabetes mellitus and poor glycemic control increase anatomical-functional discordance assessed by IVUS and QFR in patients with intermediate coronary lesions?
Odds Ratio: 2.053 (95% CI 1.137–3.707)
p-value: p=0.017
In patients with intermediate coronary lesions, diabetes mellitus—especially with poor glycemic control—is associated with a significant discordance between IVUS-derived anatomical severity and QFR-defined functional severity, suggesting QFR alone may underestimate risk in this population.
QFR may underestimate risk in diabetics with intermediate lesions; hypothesis-generating for integrated assessment pending prospective validation.
BACKGROUND: Data regarding the performance of computational fractional flow reserve in patients with diabetes mellitus (DM) remain scarce. This study sought to explore the impact of DM on quantitative flow ratio (QFR) and its association with intravascular ultrasound (IVUS)-derived anatomical references. METHODS AND RESULTS: and PB ≥70; OR 2.053, 95% CI: 1.137-3.707, P=0.017). When considering the effect of glycemic control, HbA1c was an independent predictor of anatomical-functional discordance (OR 1.347, 95% CI: 1.089-1.667, P=0.006). CONCLUSIONS: Anatomical-functional discordance of intermediate coronary lesions assessed by IVUS and QFR is exacerbated in patients with diabetes, especially when glycemia is poorly controlled.
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Geng et al. (2022) conducted an observational in Coronary artery disease with intermediate lesions (n=330). Diabetes mellitus vs. Non-diabetic patients was evaluated on Functionally non-significant lesions (QFR >0.8) with high-risk IVUS features (MLA ≤4.0 mm2 and PB ≥70%) (OR 2.053, 95% CI 1.137-3.707, p=0.017). Diabetes mellitus independently increased the odds of anatomical-functional discordance in intermediate coronary lesions by twofold (OR 2.053) compared to non-diabetic patients, an effect exacerbated by poor glycemic control.
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