The Journal of Thoracic and Cardiovascular Surgery
AdultOutcomes of quantitative flow ratio–based functional incomplete revascularization after coronary artery bypass grafting surgery
Graphical Abstract
Section snippets
Study Participants
A post hoc analysis of the Graft Patency Between No-touch Vein Harvesting Technique and Conventional Approach in Coronary Artery Bypass Graft Surgery (PATENCY) trial was conducted. The PATENCY was a multicenter, open-labeled, randomized control trial that enrolled 2655 patients undergoing isolated CABG from 7 hospitals in China between 2017 and 2019.9,10 The study was registered at ClinicalTrials.gov (identifier: NCT03126409). The protocol of the trial was approved by the Institutional Review
Patient Characteristics
Of the 2655 participants enrolled in the PATENCY study, 17 patients were excluded for not receiving surgery. A total of 614 patients of the remaining 2638 were excluded for incomplete QFR analysis (393 with angiogram unreadable or loss of image, and 220 due to 1 or more vessels not analyzable by QFR). Detailed reasons for exclusion of QFR assessment are shown in Figure 1. Comparison of the baseline characteristics and outcomes between the include and excluded patients are shown in Table E1,
Discussion
The main findings of the present post hoc analysis showed that both functional and anatomic ICR were associated with significantly higher risks of composite MACCE at 12 months of follow-up. In the anatomic ICR subgroup, this association became insignificant when judged as CR by QFR. The rates of all-cause mortality were of no significant difference between the CR and ICR groups, whether by the assessment of QFR or anatomy.
Our findings reemphasized the clinical benefit of achieving CR in
Conclusions
In this retrospective analysis of patients undergoing CABG surgery, both QFR judged functional ICR and anatomic ICR significantly increased the risk of MACCE at 12-month follow-up. However, when the revascularization was considered anatomically incomplete but judged as functionally complete by the QFR, the association was not statistically significant. Compared with anatomic judgment by angiography alone, the QFR can be considered a supplementary tool for decision-making of revascularization in
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Cited by (1)
Institutional Review Board Date and Number: October 25, 2016. Approval No: 2016-827.
Informed consent was obtained from all participants.
M.T., B.X., and L.C. contributed equally to this article.