Key result
Balloon angioplasty yields suboptimal coronary flow reserve in ~48% of patients, linked to female gender.
Why the study?
Flow velocity parameters and predictors of a suboptimal coronary flow reserve after balloon angioplasty were not well characterized.
What are the predictors of a suboptimal coronary flow reserve following coronary balloon angioplasty?
Cohort (n=183)
What are the predictors of a suboptimal coronary flow reserve following coronary balloon angioplasty?
Older age, female gender, and elevated pre-procedural baseline average peak velocity independently predict suboptimal coronary flow reserve after balloon angioplasty.
Answers are grounded in this paper and cite their sources.
Age, female sex, and elevated baseline flow velocity predict post-PTCA suboptimal CFR; hypothesis-generating in this cohort and requires prospective validation before guiding practice.
AIMS: This study was conducted to analyse flow velocity parameters and predictors of a suboptimal coronary flow reserve (<2.5) following balloon angioplasty. METHODS: Two hundred and twenty-five patients underwent sequential intracoronary Doppler as part of the DEBATE I study. Of these, 183, with complete angiography and Doppler at the 6-month follow-up, were included. Univariate and multivariate logistic analysis was performed to identify independent predictors of post-procedural suboptimal coronary flow reserve, defined as coronary flow reserve <2.5. RESULTS: Forty-eight per cent (n=88) of the patients achieved a suboptimal coronary flow reserve. These patients had higher baseline velocities (cm.s(-1)) before balloon angioplasty (18+/-9 vs 14+/-6, P=0.004), after balloon angioplasty (22+/-11 vs 14+/-5, P<0.001) and at follow-up (19+/-9 vs 16+/-6, P=0.011) than the optimal coronary flow reserve group. Although the suboptimal group had lower hyperaemic velocities (cm.s(-1)) after balloon angioplasty than the optimal group (42+/-17 vs 49+/-16, P=0.008), these velocities became similar at follow-up. Increasing age (odds ratio, OR 1.071, P=0.0002), female gender (OR 2.52, P=0.014) and increasing pre-procedural baseline average peak velocities (OR 1.056, P<0.001) were found to be independent predictors of a suboptimal coronary flow reserve following balloon angioplasty. CONCLUSION: A suboptimal coronary flow reserve was associated with (1) a chronically elevated baseline average peak velocity (2) a transient deficit in the hyperaemic average peak velocity (3) the elderly, and female gender.
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Mariano Albertal (2002) conducted a cohort in Coronary artery disease undergoing balloon angioplasty (n=183). Balloon angioplasty was evaluated on Suboptimal coronary flow reserve (<2.5). A suboptimal coronary flow reserve (<2.5) occurred in 48% of patients after balloon angioplasty and was independently predicted by increasing age, female gender (OR 2.52), and elevated baseline velocity.
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