Role of fractional flow reserve in guiding intervention for borderline coronary lesions

Objective:This study investigated the clinical efficacy and value of fractional flow reserve(FFR)in guiding the treatment of borderline coronary lesions.Methods:Forty-three patients with borderline coronary lesions,as demonstrated by coronary angiography,and who had FFR measurements were selected.The patients were grouped accord-ing to FFR values.All patients were evaluated 6 months after surgery to record major adverse cardiac events(MACE[sudden cardiac death,non-fatal myocardial infarction,or revasculariza-tion])and recurrence of angina pectoris.Results:After the 6-month follow-up,no sudden cardiac deaths or myocardial infarctions occurred in either group,and there were no statistically significant differences(P>0.05).Inter-group comparisons showed that in the groups with a FFR<0.75,the recurrence rate of angina pectoris in the PCI group was significantly lower than the drug therapy group(0.08%vs.0.27%,P<0.05).In contrast,the recurrence rate of angina pectoris in the PCI group among the groups with a FFR<0.75 revealed no statistical significance when compared to the groups with a FFR≥0.75(0.08%vs.0.05%,P>0.05).The recurrence rate of angina pectoris in the simple drug therapy group among the groups with a FFR<0.75 was higher than the same groups with a FFR≥0.75(0.27%vs.0.05%,P<0.05).Conclusion:When coronary intervention is used to treat borderline lesions,guiding inter-ventional therapy with measurement of FFR does not increase the incidence of adverse cardiovas-cular events in the short term and can better guide PCI therapy.

Combined effect of atorvastatin and probucol on plasma cystatin C levels and severity of coronary lesion in patients with borderline coronary lesion

Background The plasma cystatin C concentration （PcyC） has been demonstrated to have prognostic value in acute coronary syndrome, but the study of PcyC in patients with borderline coronary lesions is limited. Moreover, the effects of atorvastatin and probucol on PcyC and the severity of coronary lesions are unknown. This study was to evaluate the effects of the combination of atorvastatin and probucol on PcyC and severity of coronary lesion in patients with borderline coronary lesions. Methods One hundred and thirty consecutive patients with borderline coronary lesions （40% to 60% isolated single stenosis assessed by quantitative coronary angiography） were enrolled into the borderline coronary lesion （BCL） group, and one hundred and thirty-six subjects without coronary lesions comprised the controls （CTR）. The subjects in the BCL group were randomized into routine treatment （RTT, n=60）, and combined treatment with atorvastatin 20 mg plus probucol 1.0 g daily added to routine medication （CBT, n=70）, both groups were treated for 6 months continuously. The levels of PcyC, high-sensitive C-reactive protein （hs-CRP）, total cholesterol （TC）, low-density lipoprotein cholesterol （LDL-C）, high-density lipoprotein cholesterol （HDL-C）, and triglycerides （TG） were determined. One hundred and four subjects in the BCL group were rechecked by coronary angiography. Results PcyC levels were significantly higher in the BCL group than in the CTR group; （2003.26＋825.73） ng/ml vs. （1897.83＋664.46） ng/ml （P 〈0.01）. Compared with patients in the RTT group, the levels of PcyC, TC, LDL-C, TG and hs-CRP were significantly lower in the CBT group （P 〈0.05）. Moreover, there was a trend towards a slight decrease in the RTT patients, （54.38＋10.67）% vs. （50.29＋9.89）% （P 〉0.05）, and a significant decrease in the CBT patients, （53.65＋9.48%） vs. （40.38＋12.93）% （P 〈0.05）, in the mean percent stenosis of borderline coronary lesions before and after six months of treatment. Conclusions Cystatin C played an important role in with the severity of coronary lesions. The combination the treatment of choice. the development of coronary artery disease, and was associated of atorvastatin and probucol decreased PcyC levels, and could be