Frontiers in Cardiovascular Medicine (Mar 2022)
Deceleration Capacity Improves Prognostic Accuracy of Relative Increase and Final Coronary Physiology in Patients With Non-ST-Elevation Acute Coronary Syndrome
- Jun Wang,
- Jun Wang,
- Jun Wang,
- Jun Wang,
- Chengzhe Liu,
- Chengzhe Liu,
- Chengzhe Liu,
- Chengzhe Liu,
- Fuding Guo,
- Fuding Guo,
- Fuding Guo,
- Fuding Guo,
- Zhen Zhou,
- Zhen Zhou,
- Zhen Zhou,
- Zhen Zhou,
- Liping Zhou,
- Liping Zhou,
- Liping Zhou,
- Liping Zhou,
- Yueyi Wang,
- Yueyi Wang,
- Yueyi Wang,
- Yueyi Wang,
- Huaqiang Chen,
- Huaqiang Chen,
- Huaqiang Chen,
- Huaqiang Chen,
- Huixin Zhou,
- Huixin Zhou,
- Huixin Zhou,
- Huixin Zhou,
- Zhihao Liu,
- Zhihao Liu,
- Zhihao Liu,
- Zhihao Liu,
- Shoupeng Duan,
- Shoupeng Duan,
- Shoupeng Duan,
- Shoupeng Duan,
- Ji Sun,
- Ji Sun,
- Ji Sun,
- Ji Sun,
- Qiang Deng,
- Qiang Deng,
- Qiang Deng,
- Qiang Deng,
- Saiting Xu,
- Saiting Xu,
- Saiting Xu,
- Saiting Xu,
- Hong Jiang,
- Hong Jiang,
- Hong Jiang,
- Hong Jiang,
- Lilei Yu,
- Lilei Yu,
- Lilei Yu,
- Lilei Yu
Affiliations
- Jun Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Jun Wang
- Cardiac Autonomic Nervous System Research Centre of Wuhan University, Wuhan, China
- Jun Wang
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Jun Wang
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Chengzhe Liu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Chengzhe Liu
- Cardiac Autonomic Nervous System Research Centre of Wuhan University, Wuhan, China
- Chengzhe Liu
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Chengzhe Liu
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Fuding Guo
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Fuding Guo
- Cardiac Autonomic Nervous System Research Centre of Wuhan University, Wuhan, China
- Fuding Guo
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Fuding Guo
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Zhen Zhou
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Zhen Zhou
- Cardiac Autonomic Nervous System Research Centre of Wuhan University, Wuhan, China
- Zhen Zhou
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Zhen Zhou
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Liping Zhou
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Liping Zhou
- Cardiac Autonomic Nervous System Research Centre of Wuhan University, Wuhan, China
- Liping Zhou
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Liping Zhou
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Yueyi Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Yueyi Wang
- Cardiac Autonomic Nervous System Research Centre of Wuhan University, Wuhan, China
- Yueyi Wang
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Yueyi Wang
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Huaqiang Chen
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Huaqiang Chen
- Cardiac Autonomic Nervous System Research Centre of Wuhan University, Wuhan, China
- Huaqiang Chen
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Huaqiang Chen
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Huixin Zhou
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Huixin Zhou
- Cardiac Autonomic Nervous System Research Centre of Wuhan University, Wuhan, China
- Huixin Zhou
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Huixin Zhou
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Zhihao Liu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Zhihao Liu
- Cardiac Autonomic Nervous System Research Centre of Wuhan University, Wuhan, China
- Zhihao Liu
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Zhihao Liu
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Shoupeng Duan
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Shoupeng Duan
- Cardiac Autonomic Nervous System Research Centre of Wuhan University, Wuhan, China
- Shoupeng Duan
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Shoupeng Duan
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Ji Sun
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Ji Sun
- Cardiac Autonomic Nervous System Research Centre of Wuhan University, Wuhan, China
- Ji Sun
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Ji Sun
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Qiang Deng
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Qiang Deng
- Cardiac Autonomic Nervous System Research Centre of Wuhan University, Wuhan, China
- Qiang Deng
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Qiang Deng
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Saiting Xu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Saiting Xu
- Cardiac Autonomic Nervous System Research Centre of Wuhan University, Wuhan, China
- Saiting Xu
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Saiting Xu
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Hong Jiang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Hong Jiang
- Cardiac Autonomic Nervous System Research Centre of Wuhan University, Wuhan, China
- Hong Jiang
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Hong Jiang
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Lilei Yu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Lilei Yu
- Cardiac Autonomic Nervous System Research Centre of Wuhan University, Wuhan, China
- Lilei Yu
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Lilei Yu
- Hubei Key Laboratory of Cardiology, Wuhan, China
- DOI
- https://doi.org/10.3389/fcvm.2022.848499
- Journal volume & issue
-
Vol. 9
Abstract
BackgroundBoth coronary physiology and deceleration capacity (DC) showed prognostic efficacy for patients with acute coronary syndrome (ACS). This retrospective cohort study was performed to evaluate the prognostic implication of DC combined with the relative increase and final coronary physiology as detected by quantitative flow ratio (QFR) for patients with non-ST-elevation ACS (NSTE-ACS) who underwent complete and successful percutaneous coronary intervention (PCI).MethodsPatients with NSTE-ACS who underwent PCI with pre- and post-procedural QFR in our department between January 2018 and November 2019 were included. The 24-hour deceleration capacity (DC 24h) was obtained via Holter monitoring. The incidence of major adverse cardiac and cerebrovascular events (MACCEs) during follow up was defined as the primary outcome. The optimal cutoffs of the relative increase, final QFR, and DC 24h for prediction of MACCEs were determined via receiver operating characteristic (ROC) analysis and the predictive efficacies were evaluated with multivariate Cox regression analysis.ResultsOverall, 240 patients were included. During a mean follow up of 21.3 months, 31 patients had MACCEs. Results of multivariate Cox regression analyses showed that a higher post-PCI QFR [adjusted hazard ratio (HR): 0.318; 95% confidence interval (CI): 0.129–0.780], a higher relative QFR increase (HR: 0.161; 95% CI: 0.066–0.391], and a higher DC (HR: 0.306; 95% CI: 0.134–0.701) were all independent predictors of lower risk of MACCEs. Subsequently, incorporating low DC (≤2.42) into the risk predicting model with clinical variables, the predictive efficacies of low relative QRS increase (≤23%) and low post-PCI QFR (≤0.88) for MACCEs were both significantly improved.ConclusionsThe DC combined with relative increase and final coronary physiology may improve the predictive efficacy of existing models based on clinical variables for MACCEs in NSTE-ACS patients who underwent complete and successful PCI.
Keywords
- deceleration capacity
- non-ST-elevation acute coronary syndrome (NSTE-ACS)
- coronary physiology
- major adverse cardiac and cerebrovascular events (MACCEs)
- quantitative flow ratio (QFR)