Universität zu Köln

Reith, Sebastian, Battermann, Simone, Hellmich, Martin, Marx, Nikolaus and Burgmaier, Mathias (2014). Impact of type 2 diabetes mellitus and glucose control on fractional flow reserve measurements in intermediate grade coronary lesions. Clin. Res. Cardiol., 103 (3). S. 191 - 202. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1861-0692

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Abstract

Hemodynamic relevance of intermediate grade coronary stenoses is accurately assessed by fractional flow reserve (FFR) measurements. However, the reliability of FFR in patients with type 2 diabetes mellitus (DM) and inadequate glucose control (IGC) is incompletely explored. This study aimed to investigate the impact of DM and IGC on the relationship between FFR measurements and quantitative coronary angiography (QCA)-derived morphological parameters. We performed FFR and QCA in 266 intermediate grade lesions of 224 patients (113 non-DM and 111 DM) with stable coronary artery disease. Diabetic patients were categorized into groups with adequate (Hb(A1C) < 7 %) and inadequate (Hb(A1c) a parts per thousand yen7 %) glucose control. Intermediate grade lesions from all-DM versus non-DM patients differed significantly in lesion length (LL) (10.91 +/- A 5.79 mm versus 9.23 +/- A 3.85 mm, p = 0.005) and hemodynamic relevance (FFR a parts per thousand currency sign0.8, 37.7 % versus 24.2 %, p = 0.018). FFR measurements in non-DM, all-DM and DM-IGC patients correlated significantly with percent diameter stenosis (%DS) [non-DM: r (2) = 0.075 (p = 0.007); all-DM: r (2) = 0.254 (p < 0.001), DM-IGC: r (2) = 0.301 (p < 0.001)] and LL [non-DM: r (2) = 0.356; all-DM: r (2) = 0.580, DM-IGC: r (2) = 0.513 (all p < 0.001)]. There was a better correlation between FFR and both %DS (p = 0.022) and LL (p = 0.011) among all-DM compared to non-DM patients. Receiver-operating curve analysis demonstrated that among all QCA-derived parameters LL had the best diagnostic efficacy to predict FFR a parts per thousand currency sign0.8 for non-DM (AUC 0.911, 95 % CI 0.861-0.960, best cut-off value 9.22 mm), all-DM (AUC 0.967, 95 % CI 0.942-0.991, best cut-off value 9.97 mm) and DM-IGC (AUC 0.960, 95 % CI 0.920-0.999, best cut-off value 9.97 mm) patients. Our data in intermediate grade lesions suggest that FFR is reliable in DM patients and LL is the best predictor for hemodynamic relevance in patients without and with diabetes, irrespective of the glycemic state.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Reith, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Battermann, Simone UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Marx, Nikolaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Burgmaier, Mathias UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-444826
DOI:	10.1007/s00392-013-0633-7
Journal or Publication Title:	Clin. Res. Cardiol.
Volume:	103
Number:	3
Page Range:	S. 191 - 202
Date:	2014
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1861-0692
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OPTICAL COHERENCE TOMOGRAPHY; SIROLIMUS-ELUTING STENTS; FUNCTIONAL-SIGNIFICANCE; INTRACORONARY ADENOSINE; INTRAVASCULAR ULTRASOUND; UNSTABLE ANGINA; SEVERITY; TERM; REVASCULARIZATION; ANGIOGRAPHY Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/44482