Abstract
Purpose: The change in coronary physiology from lipid-lowering therapy (LLT) lacks an appropriate method of examination. Quantitative flow ratio (QFR) is a novel angiography-based approach allowing rapid assessment of coronary physiology. This study sought to determine the impact of low-density lipoprotein cholesterol (LDL-C) goal achievement on coronary physiology through QFR.Methods: Cases involving percutaneous coronary intervention (PCI) and 1-year angiographic follow-up were screened and assessed by QFR analysis. Patients were divided into two groups according to the LDL-C level at the 1-year follow-up: (1) goal-achievement group (LDL-C < 1.8 mmol/L or reduction of ≥50%, n = 146, lesion = 165) and (2) non-achievement group (n = 286, lesion = 331). All QFR data and major adverse cardiovascular and cerebrovascular events (MACCEs) at 1 year were compared between groups.Results: No differences between the groups in quantitative coronary angiography (QCA) data or QFR post-PCI were found. At the 1-year follow-up, lower percentage diameter stenosis (DS%) and percentage area stenosis (AS%) were recorded in the goal-achievement group (27.89 ± 10.16 vs. 30.93 ± 12.03, p = 0.010, 36.57 ± 16.12 vs. 41.68 ± 17.39, p = 0.003, respectively). Additionally, a better change in QFR was found in the goal-achievement group (0.003 ± 0.068 vs. −0.018 ± 0.086, p = 0.007), with a lower incidence of physiological restenosis and MACCEs (2.1 vs. 8.4%, p = 0.018, 5.4 vs. 12.6%, p = 0.021, respectively).Conclusion: Evaluated by QFR, patients who achieved the LDL-C goal appear to have a better coronary physiological benefit. This group of patients also has a better clinical outcome.
Highlights
The prognosis of patients with coronary artery disease (CAD) has been much improved by percutaneous coronary intervention (PCI), patients who undergo this treatment still have an increased risk of recurrent cardiovascular events [1]
A total of 734 lesions in 606 patients who underwent PCI were collected, with 496 lesions in 432 patients examined for the final analysis
No significant differences in age, sex, hypertension, diabetes mellitus, renal insufficiency, smoking, history of previous acute myocardial infarction (AMI) or PCI, or type of CAD were found between the two groups
Summary
The prognosis of patients with coronary artery disease (CAD) has been much improved by percutaneous coronary intervention (PCI), patients who undergo this treatment still have an increased risk of recurrent cardiovascular events [1]. As a crucial part of cardiac disease management, lipid modification is associated with reduced cardiovascular mortality. It is well-established that decreasing the low-density lipoprotein cholesterol (LDL-C) concentration in very high-risk patients is the primary target to reduce the risk of cardiovascular events [2, 3]. Lipid-lowering therapy (LLT) has been the cornerstone of medical therapy for primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD) [4, 5]. Emerging data obtained by novel imaging modalities suggest that LLT might have a greater impact on modulating lipid content vs plaque volume, which makes multidisciplinary assessment of clinical outcome from LLT an important concern. There is no appropriate method to assess the change in coronary physiology due to LLT
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
