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Safi, Morteza
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Medicine & Pharmacology

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Impact of Lesion Length on Functional Significance in Intermediate Coronary Lesions Safi, Morteza; Khaheshi, Isa; Eslami, Vahid; Beheshtian, Mohammad Mehdi; Naderian, Mohammadreza
International Journal of Cardiovascular Practice Vol 2, No 3 (2017)
Publisher : International Journal of Cardiovascular Practice

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (115.576 KB) | DOI: 10.21859/ijcp-020301

Abstract

Introduction: The present study aimed at assessing the role of lesion length in predicting Fractional Flow Reserve (FFR) value for physiological evaluation of intermediate coronary lesions.Methods: In the current study, 68 patients with 83 coronary lesions were enrolled. All of the patients in this study underwent routine coronary angiography, according to appropriate indications. To evaluate physiologically significant intermediate coronary stenosis (defined between 40% and 70% on visual estimation), the Fractional Flow Reserve (FFR) study was performed and the Quantitative Coronary Angiography (QCA) data were also assessed for measurement of lesion length. The correlation between QCA data and FFR values was also examined.Results: Eighty-three lesions were evaluated from 68 patients. Stenosis was considered physiologically significant when FFR was lower than 0.75. The FFR was significant in twelve lesions (14.5%). There was a negative correlation between FFR value and lesion length (r = -0.294 and P = 0.013). Moreover, lesion length in physiologically significant FFR group (21.07  ± 6.9) was greater than that of the non-significant FFR group (15.23 ± 6.5) (P value < 0.05). Furthermore, the correlation between QCA data and FFR values was also investigated, yet, there was only a positive correlation between FFR and Minimum Luminal Diameter (MLD) values (r = 0.248 and P value = 0.04). The Receiver Operating Characteristic (ROC) curve analysis for predicting the significant FFR value demonstrated that a lesion length greater than 17.5 mm was the best cut-off point for prediction of the significant FFR value with acceptable sensitivity and specificity of 83.3% and 68.8%, respectively.Conclusions: There is a negative correlation between lesion length and FFR value in intermediate coronary lesions. In addition, a lesion length greater than 17.5 mm is the best cut- off point for prediction of significant FFR values.
Correlation of platelet indices with TIMI frame count in patients undergoing primary PCI due to ST-segment elevation myocardial infarction Salehi, Ayoub; Namazi, Mohammad Hasan; Safi, Morteza; Vakili, Hossein; Saadat, Habibollah; Alipour Parsa, Saeed; Akbarzadeh, Mohammad Ali; Moshtaghi, Ameneh; Khaheshi, Isa
International Journal of Cardiovascular Practice Vol 4, No 3 (2019)
Publisher : International Journal of Cardiovascular Practice

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (605.876 KB)

Abstract

Introduction: Given the fundamental role of platelet indices in the development of atherosclerotic plaque, these indices may play a predictive role for the occurrence of disturbed coronary reperfusion. The present study evaluated the relationship between platelet indices and coronary reperfusion status based on TIMI frame count.Methods: This cross-sectional study was conducted on 98 consecutive patients with STEMI who were candidate for primary PCI at Modarres Hospital in Tehran between January 2016 and January 2018. Venous samples were extracted from all patients before primary PCI. To assess the condition of coronary reperfusion after primary PCI, TIMI frame count related to culprit artery in acute myocardial infarction was determined.Results: The TIMI frame count was positively associated with platelet count (r = 0.320, p = 0.001) and more strongly with platelet to lymphocyte ratio (r = 0.375, p < 0.001), but not with other platelet indices such as PDW, MPV, or PLCR. According to the ROC curve analysis, platelet to lymphocyte ratio was introduced as a valuable parameter for differentiating complete from disturbed reperfusion (AUC = 0.735, 95%CI: 0.613 ? 0.858, P = 0.001). The best cutoff value for platelet to lymphocyte ratio in predicting disturbed reperfusion was 146.5 yielding a sensitivity of 81.8% and a specificity of 60.5%. However, other platelet indices could not present this predictive role.        Conclusion: From different platelet indices, the platelet to lymphocyte ratio with predictive accuracy and sensitivity predict coronary perfusion impairment based on the increase in TIMI frame count.
Co-Authors Akbarzadeh, Mohammad Ali Alipour Parsa, Saeed Beheshtian, Mohammad Mehdi Eslami, Vahid Khaheshi, Isa Moshtaghi, Ameneh Naderian, Mohammadreza Namazi, Mohammad Hasan Saadat, Habibollah Salehi, Ayoub Vakili, Hossein