In a nutshell
This study aimed to investigate the effects of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) on maximum blood flow in patients with coronary artery disease (CAD). The main finding of the study was that these procedures stopped the decrease in maximum blood flow through the heart arteries.
Some background
CAD is when plaque builds up in the blood vessels to the heart. This leads to a decrease in the blood flow to the heart. The main treatment options for CAD are PCI, CABG or treatment with medications alone. PCI is where a catheter is inserted through a blood vessel in the arm or the leg and fed it up to the blood vessels of the heart. A balloon is then inflated to widen the vessels. Stents may also be placed to keep the vessels open. The other option is CABG. This is where vessels are taken from the leg and used to bypass the blockage in the heart vessels.
When the heart needs more oxygen, the blood vessels have the ability to dilate to increase the amount of blood flowing to the heart muscle. The maximum increase in blood flow is called the coronary flow reserve (CFR). CFR is reduced in CAD. It can be used to measure how effective a treatment has been in increasing blood flow to the heart.
The effect of PCI and CABG on CFR is not known.
Methods & findings
This study included 75 patients. 28 underwent PCI, 22 underwent CABG and 25 were treated with medicine alone (MT). CFR was measured before and after 6 months.
After 6 months, only CABG was associated with a significant increase in CFR. In patients who had a CFR less than 2.0, CFR significantly increased in the PCI and CABG groups. A reduction in the SYNTAX score (risk of death) was associated with an increase in CFR.
The bottom line
The authors concluded that PCI and CABG stopped CFR reductions in patients with CAD. They suggested that patients with a lower CFR may be more likely to benefit from PCI or CABG.
The fine print
This study included a very small number of patients. More studies are required for better evidence.
Published By :
Cardiovascular Research
Date :
Jan 01, 2019
