Authors: Sebastian Reith Simone Battermann Martin Hellmich Nikolaus Marx Mathias Burgmaier
Publish Date: 2013/11/22
Volume: 103, Issue: 3, Pages: 191-201
Abstract
Hemodynamic relevance of intermediate grade coronary stenoses is accurately assessed by fractional flow reserve FFR measurements However the reliability of FFR in patients with type 2 diabetes mellitus DM and inadequate glucose control IGC is incompletely explored This study aimed to investigate the impact of DM and IGC on the relationship between FFR measurements and quantitative coronary angiography QCAderived morphological parametersWe performed FFR and QCA in 266 intermediate grade lesions of 224 patients 113 nonDM and 111 DM with stable coronary artery disease Diabetic patients were categorized into groups with adequate HbA1C 7 and inadequate HbA1c ≥7 glucose controlIntermediate grade lesions from allDM versus nonDM patients differed significantly in lesion length LL 1091 ± 579 mm versus 923 ± 385 mm p = 0005 and hemodynamic relevance FFR ≤08 377 versus 242 p = 0018 FFR measurements in nonDM allDM and DMIGC patients correlated significantly with percent diameter stenosis DS nonDM r 2 = 0075 p = 0007 allDM r 2 = 0254 p 0001 DMIGC r 2 = 0301 p 0001 and LL nonDM r 2 = 0356 allDM r 2 = 0580 DMIGC r 2 = 0513 all p 0001 There was a better correlation between FFR and both DS p = 0022 and LL p = 0011 among allDM compared to nonDM patients Receiveroperating curve analysis demonstrated that among all QCAderived parameters LL had the best diagnostic efficacy to predict FFR ≤08 for nonDM AUC 0911 95 CI 0861–0960 best cutoff value 922 mm allDM AUC 0967 95 CI 0942–0991 best cutoff value 997 mm and DMIGC AUC 0960 95 CI 0920–0999 best cutoff value 997 mm patients
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