Functional Complete Revascularization as Determined by an Optimized Scoring System After Revascularization: A Post Hoc Analysis from Multi‐Center PANDA III Trial
Abstract Functional complete revascularization (CR) after percutaneous coronary intervention (PCI) as determined by classic residual functional SYNTAX score (c‐rFSS) has been associated with improved prognosis. In this study, the c‐rFSS algorithm is optimized for a novel modified rFSS (m‐rFSS) and p...
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Wiley
2025-04-01
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| Series: | Advanced Science |
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| Online Access: | https://doi.org/10.1002/advs.202415961 |
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| author | Rui Zhang Shaoyu Wu Qianqian Liu Changdong Guan Hao‐Yu Wang Sheng Yuan Lihua Xie Yunfei Huang Zheng Qiao Weida Liu Rui Fu Lei Feng Chenggang Zhu Lei Song Dong Yin Kefei Dou |
| author_facet | Rui Zhang Shaoyu Wu Qianqian Liu Changdong Guan Hao‐Yu Wang Sheng Yuan Lihua Xie Yunfei Huang Zheng Qiao Weida Liu Rui Fu Lei Feng Chenggang Zhu Lei Song Dong Yin Kefei Dou |
| author_sort | Rui Zhang |
| collection | DOAJ |
| description | Abstract Functional complete revascularization (CR) after percutaneous coronary intervention (PCI) as determined by classic residual functional SYNTAX score (c‐rFSS) has been associated with improved prognosis. In this study, the c‐rFSS algorithm is optimized for a novel modified rFSS (m‐rFSS) and prognostic implications of this novel scoring is determined. The m‐rFSS algorithm is updated for 2 clinical scenarios, i.e., 1) lesions with suboptimal functional results, and 2) angiographic diameter stenosis <50% but functionally significant stenoses, which are not scored by c‐rFSS. The major outcome is a 2‐year major adverse cardiac event (MACE). A total of 1,555 patients analyzable for both c‐rFSS and m‐rFSS are included. After calculating m‐rFSS, 12.0% (187/1,555) of patients with c‐rFSS‐based functional CR (c‐rFSS = 0) are reclassified as having m‐rFSS‐based incomplete revascularization (IR, m‐rFSS>0); thus, 377 (21.7%) patients have c‐rFSS‐based functional IR whereas 524 (33.7%) has m‐rFSS‐based IR. Patients with m‐rFSS‐based functional IR (m‐rFSS>0) show a significantly higher risk for major MACE outcome (20.8% vs 5.9%; adjusted hazard ratio 3.32, 95% confidence interval: 2.34–4.71) than patients with functional CR (m‐rFSS = 0). The m‐rFSS is more predictive of 2‐year MACE than c‐rFSS (difference in C‐index 0.07, p < 0.001). In this study, we optimized the classic scoring algorithm to develop a novel scoring system (m‐rFSS), and revascularization completeness determined by m‐rFSS is markedly associated with a 2‐year prognosis. |
| format | Article |
| id | doaj-art-4a33d12062ec4f65a8d3d36059a0a6f6 |
| institution | OA Journals |
| issn | 2198-3844 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wiley |
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| series | Advanced Science |
| spelling | doaj-art-4a33d12062ec4f65a8d3d36059a0a6f62025-08-20T02:09:32ZengWileyAdvanced Science2198-38442025-04-011214n/an/a10.1002/advs.202415961Functional Complete Revascularization as Determined by an Optimized Scoring System After Revascularization: A Post Hoc Analysis from Multi‐Center PANDA III TrialRui Zhang0Shaoyu Wu1Qianqian Liu2Changdong Guan3Hao‐Yu Wang4Sheng Yuan5Lihua Xie6Yunfei Huang7Zheng Qiao8Weida Liu9Rui Fu10Lei Feng11Chenggang Zhu12Lei Song13Dong Yin14Kefei Dou15Cardiometabolic Medicine Center National Clinical Research Center for Cardiovascular Diseases Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 ChinaCardiometabolic Medicine Center National Clinical Research Center for Cardiovascular Diseases Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 ChinaCardiometabolic Medicine Center National Clinical Research Center for Cardiovascular Diseases Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 ChinaDepartment of Cardiology National Clinical Research Center for Cardiovascular Diseases Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 ChinaCardiometabolic Medicine Center National Clinical Research Center for Cardiovascular Diseases Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 ChinaCardiometabolic Medicine Center National Clinical Research Center for Cardiovascular Diseases Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 ChinaCatheterization Laboratories National Clinical Research Center for Cardiovascular Diseases Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 ChinaCatheterization Laboratories National Clinical Research Center for Cardiovascular Diseases Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 ChinaCardiometabolic Medicine Center National Clinical Research Center for Cardiovascular Diseases Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 ChinaState Key Laboratory for Complex Severe, and Rare Diseases Peking Union Medical College Hospital Chinese Academy of Medical Sciences Beijing 100730 ChinaDepartment of Cardiology National Clinical Research Center for Cardiovascular Diseases Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 ChinaDepartment of Cardiology National Clinical Research Center for Cardiovascular Diseases Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 ChinaDepartment of Cardiology National Clinical Research Center for Cardiovascular Diseases Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 ChinaDepartment of Cardiology National Clinical Research Center for Cardiovascular Diseases Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 ChinaDepartment of Cardiology National Clinical Research Center for Cardiovascular Diseases Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 ChinaCardiometabolic Medicine Center National Clinical Research Center for Cardiovascular Diseases Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 ChinaAbstract Functional complete revascularization (CR) after percutaneous coronary intervention (PCI) as determined by classic residual functional SYNTAX score (c‐rFSS) has been associated with improved prognosis. In this study, the c‐rFSS algorithm is optimized for a novel modified rFSS (m‐rFSS) and prognostic implications of this novel scoring is determined. The m‐rFSS algorithm is updated for 2 clinical scenarios, i.e., 1) lesions with suboptimal functional results, and 2) angiographic diameter stenosis <50% but functionally significant stenoses, which are not scored by c‐rFSS. The major outcome is a 2‐year major adverse cardiac event (MACE). A total of 1,555 patients analyzable for both c‐rFSS and m‐rFSS are included. After calculating m‐rFSS, 12.0% (187/1,555) of patients with c‐rFSS‐based functional CR (c‐rFSS = 0) are reclassified as having m‐rFSS‐based incomplete revascularization (IR, m‐rFSS>0); thus, 377 (21.7%) patients have c‐rFSS‐based functional IR whereas 524 (33.7%) has m‐rFSS‐based IR. Patients with m‐rFSS‐based functional IR (m‐rFSS>0) show a significantly higher risk for major MACE outcome (20.8% vs 5.9%; adjusted hazard ratio 3.32, 95% confidence interval: 2.34–4.71) than patients with functional CR (m‐rFSS = 0). The m‐rFSS is more predictive of 2‐year MACE than c‐rFSS (difference in C‐index 0.07, p < 0.001). In this study, we optimized the classic scoring algorithm to develop a novel scoring system (m‐rFSS), and revascularization completeness determined by m‐rFSS is markedly associated with a 2‐year prognosis.https://doi.org/10.1002/advs.202415961coronary artery diseasefunctional complete revascularizationpercutaneous coronary interventionquantitative flow ratioresidual functional SYNTAX score |
| spellingShingle | Rui Zhang Shaoyu Wu Qianqian Liu Changdong Guan Hao‐Yu Wang Sheng Yuan Lihua Xie Yunfei Huang Zheng Qiao Weida Liu Rui Fu Lei Feng Chenggang Zhu Lei Song Dong Yin Kefei Dou Functional Complete Revascularization as Determined by an Optimized Scoring System After Revascularization: A Post Hoc Analysis from Multi‐Center PANDA III Trial Advanced Science coronary artery disease functional complete revascularization percutaneous coronary intervention quantitative flow ratio residual functional SYNTAX score |
| title | Functional Complete Revascularization as Determined by an Optimized Scoring System After Revascularization: A Post Hoc Analysis from Multi‐Center PANDA III Trial |
| title_full | Functional Complete Revascularization as Determined by an Optimized Scoring System After Revascularization: A Post Hoc Analysis from Multi‐Center PANDA III Trial |
| title_fullStr | Functional Complete Revascularization as Determined by an Optimized Scoring System After Revascularization: A Post Hoc Analysis from Multi‐Center PANDA III Trial |
| title_full_unstemmed | Functional Complete Revascularization as Determined by an Optimized Scoring System After Revascularization: A Post Hoc Analysis from Multi‐Center PANDA III Trial |
| title_short | Functional Complete Revascularization as Determined by an Optimized Scoring System After Revascularization: A Post Hoc Analysis from Multi‐Center PANDA III Trial |
| title_sort | functional complete revascularization as determined by an optimized scoring system after revascularization a post hoc analysis from multi center panda iii trial |
| topic | coronary artery disease functional complete revascularization percutaneous coronary intervention quantitative flow ratio residual functional SYNTAX score |
| url | https://doi.org/10.1002/advs.202415961 |
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