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Incomplete revascularisation is the determinant of MACE at 1 year in ACS patients. FFR discriminates the lesions based upon ischemia, but an invasive procedure thus contains all risks and expenses of invasive procedures. Exercise testing is most widely used safe and inexpensive procedure. The aim of our study was to investigate whether exercise testing can be used or not, instead of FFR measurment in ACS patients whose culprit lesion were revascularized, and have one more borderline coronary stenoses and asymptomatic with medical therapy.
Between February 2013 and March 2015 78 NSTEACS patients whose culprit lesion were successfully revascularized; have one more borderline (%40-70) coronary stenoses to which FFR measurment was planned and asymptomatic within given period were enrolled.
When the association between exercise test parameters and FFR values were investigated by correlation analyses, we have detected statistically significant associations with all parameters except RPP. (Table 1).
Lesions were seperated serious and nonserious according to FFR. When each exercise test parameter differences between groups were tested. Duke score, exercise induced ST deviation, the sum of net ST deviation were statistically significantly different between significant and nonsignificant lesions.
With the variables Diabetes mellitus, the sum of net ST segment deviation and rate pressure product; it is hypothetically possible to produce a model that predicts the FFR cut-off value. And when we examine the probability value of 78 patients; model has %87,2 success rate.
Exercise testing can provide useful diagnostic information when considered beyond ST segment in ACS patients whose culprit lesion were revascularized, and have one more borderline coronary stenoses and asymptomatic with medical therapy.
|Total exercise time||0.244||0.031|
|The number of leads showing 0.1 mm or more ST displacement||-0.544||0.002|
|The sum of net ST segment deviation||-0.662||0.0024|
|Exercise induced ST deviation||-0.651||0.0017|
|Heart rate recovery||0.271||0.069|
|Rate Pressure Product||0.069||0.550|