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January 1, 2020Medicinski podmladakOpen Access

Patients with CFR < 2 had significantly more adverse events (56.3% vs. 25.5%; p = 0.021) and CFR < 2 was an independent predictor of adverse events (HR 0.340; 95% CI 0.146-0.788, p = 0.012).

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Why the study?

Coronary flow reserve is a non-invasive diagnostic method for assessing coronary functional capacity, but its prognostic significance in patients with RCA CTO and intermediate LAD stenosis had not been sufficiently investigated.

Does a Coronary Flow Reserve (CFR) < 2 predict adverse cardiovascular events in patients with chronic total occlusion of the right coronary artery and intermediary stenosis of the left anterior descending artery?

Population

71 patients with LAD stenosis (50-70%) and RCA CTO

Comparison

CFR < 2 vs CFR >= 2

Design

Observational cohort study

Follow-up

Mean 18.3 ± 7.1 months

Authors

LHLara Hadži-TanovićNBN BoskovicSDSrđan Dedić

Discussion

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Member takes

Overview

Should not yet change management of intermediate LAD stenosis with RCA CTO; leaves open CFR’s independent prognostic value in larger studies.

Structured PICO

Does a Coronary Flow Reserve (CFR) < 2 predict adverse cardiovascular events in patients with chronic total occlusion of the right coronary artery and intermediary stenosis of the left anterior descending artery?

P
Population
71 patients, mean age 64 ± 7 years, 84.5% male, with intermediary stenosis of the left anterior descending coronary artery (LAD) (diameter 50-70%) and chronic total occlusion (CTO) of the right coronary artery (RCA).
I
Intervention
Coronary Flow Reserve (CFR) < 2 measured by transthoracic Doppler echocardiography
C
Comparator
Coronary Flow Reserve (CFR) > 2
O
Outcome
Composite endpoint including cardiovascular death, myocardial infarction, bypass surgery, and percutaneous coronary intervention (PCI) at mean 18.3 ± 7.1 months follow-upcomposite

Coronary flow reserve < 2 measured non-invasively is an independent predictor of adverse cardiovascular events in patients with chronic total occlusion of the right coronary artery and intermediate stenosis of the left anterior descending artery.

Limitations

  • small number of patients
  • single-center study
  • data obtained via telephone

Cite This Study

Hadži-Tanović et al. (2020) studied this question.

synapsesocial.com/papers/6a80e2fc407ce5842fa8a599https://doi.org/10.5937/mp71-22174
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Long‐Term Prognostic Significance of Coronary Flow Velocity Reserve in Patients with Significant Coronary Artery Disease Not Involving the Left Anterior Descending Coronary Artery (Results from the SZEGED Study)2010 · 9 citations
  2. 2Clinical Outcome in Patients with Intermediate Stenosis of Left Anterior Descending Coronary Artery after Deferral of Revascularization on the Basis of Noninvasive Coronary Flow Reserve Measurement2008 · 14 citations
  3. 3Coronary Flow Reserve in Adults: Pathophysiology, Assessment Modalities, Clinical Applications, and Prognostic Significance2026
  4. 4Diagnosis of Coronary Restenosis Using Coronary Flow Reserve Measurements Obtained Through Transthoracic Doppler Echocardiography2008
  5. 5Impaired Coronary Flow Reserve as a Marker of Microvascular Dysfunction to Predict Long-Term Cardiovascular Outcomes, Acute Coronary Syndrome and the Development of Heart Failure2012 · 59 citations