Impact of intensively lowered low-density lipoprotein cholesterol on deferred lesion prognosis.
Aged
Anticholesteremic Agents
/ adverse effects
Biomarkers
/ blood
Cholesterol, LDL
/ blood
Coronary Artery Disease
/ diagnosis
Coronary Stenosis
/ diagnostic imaging
Disease Progression
Down-Regulation
Dyslipidemias
/ blood
Ezetimibe
/ therapeutic use
Female
Fractional Flow Reserve, Myocardial
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
/ therapeutic use
Male
Middle Aged
Myocardial Infarction
/ etiology
Myocardial Revascularization
Retrospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index
Time Factors
Time-to-Treatment
Treatment Outcome
angiography
fractional flow reserve
lipids
Journal
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
ISSN: 1522-726X
Titre abrégé: Catheter Cardiovasc Interv
Pays: United States
ID NLM: 100884139
Informations de publication
Date de publication:
01 03 2020
01 03 2020
Historique:
received:
16
03
2019
accepted:
16
05
2019
pubmed:
30
5
2019
medline:
21
10
2020
entrez:
30
5
2019
Statut:
ppublish
Résumé
The aim of this study was to investigate the impact of intensively lowered low-density lipoprotein cholesterol (LDL-C) level on the deferred lesion prognosis after revascularization deferral based on fractional flow reserve (FFR). Lowering LDL-C is associated with lower cardiovascular event rate, but its benefit on the deferred lesion prognosis has not been well evaluated. This retrospective, single-center, observational study analyzed 192 deferred lesions with FFR value >0.80 in 192 patients with stable coronary artery disease. According to the first follow-up LDL-C level, they were assigned to the LOW group (<70 mg/dL) or the HIGH group (≥70 mg/dL). Deferred lesion failure (DLF) was defined as the composite of deferred lesion revascularization and deferred vessel myocardial infarction. Of all participants, 61 and 131 patients were assigned to the LOW and the HIGH group, respectively. During the median follow-up of 2.8 years, DLF occurred in 1 and 14 patients in the LOW group and the HIGH group (1.6% and 10.7%, log-rank p = .043), respectively. The incidence of any unplanned revascularization was also significantly lower in the LOW group than in the HIGH group (3.3% vs. 14.5%, log-rank p = .032). The incidence of DLF was significantly lower in the patients with LDL-C < 70 mg/dL than in those with LDL-C ≥ 70 mg/dL at the first follow-up after FFR-based deferral of revascularization.
Sections du résumé
OBJECTIVES
The aim of this study was to investigate the impact of intensively lowered low-density lipoprotein cholesterol (LDL-C) level on the deferred lesion prognosis after revascularization deferral based on fractional flow reserve (FFR).
BACKGROUND
Lowering LDL-C is associated with lower cardiovascular event rate, but its benefit on the deferred lesion prognosis has not been well evaluated.
METHODS
This retrospective, single-center, observational study analyzed 192 deferred lesions with FFR value >0.80 in 192 patients with stable coronary artery disease. According to the first follow-up LDL-C level, they were assigned to the LOW group (<70 mg/dL) or the HIGH group (≥70 mg/dL). Deferred lesion failure (DLF) was defined as the composite of deferred lesion revascularization and deferred vessel myocardial infarction.
RESULTS
Of all participants, 61 and 131 patients were assigned to the LOW and the HIGH group, respectively. During the median follow-up of 2.8 years, DLF occurred in 1 and 14 patients in the LOW group and the HIGH group (1.6% and 10.7%, log-rank p = .043), respectively. The incidence of any unplanned revascularization was also significantly lower in the LOW group than in the HIGH group (3.3% vs. 14.5%, log-rank p = .032).
CONCLUSIONS
The incidence of DLF was significantly lower in the patients with LDL-C < 70 mg/dL than in those with LDL-C ≥ 70 mg/dL at the first follow-up after FFR-based deferral of revascularization.
Substances chimiques
Anticholesteremic Agents
0
Biomarkers
0
Cholesterol, LDL
0
Hydroxymethylglutaryl-CoA Reductase Inhibitors
0
Ezetimibe
EOR26LQQ24
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
E100-E107Informations de copyright
© 2019 Wiley Periodicals, Inc.
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