Low attenuation plaque on CTA (OR 2.78) and thrombus (OR 5.13), plaque rupture (OR 3.25), and intimal vasculature on OCT (OR 2.57) independently predicted ischemia-causing lesions (FFR ≤0.80).
Observational (n=159)
Sí
Do specific plaque characteristics assessed by coronary CTA and OCT predict ischemia-causing lesions in patients with intermediate coronary stenosis?
Specific high-risk plaque features identified on coronary CTA and OCT, such as low attenuation, thrombus, and rupture, independently predict which intermediate coronary lesions cause ischemia as measured by FFR.
Estimación del efecto: OR 2.78, 5.13, 3.25, 2.57
valor p: p=0.038, 0.042, 0.017, 0.012
Abstract Background In patients with intermediate coronary stenosis, the functional assessment with fractional flow reserve (FFR) and the anatomical assessment with optical coherence tomography (OCT) have been widely used in clinical practice. Additionally, coronary computed tomography angiography (CTA) is commonly used non-invasive imaging technique for evaluating suspected coronary artery disease before being referred for angiography. Objectives This study sought to investigate the association between FFR and plaque characteristics assessed by coronary CTA and OCT in intermediate coronary stenosis. Methods Based on the prospective multicentre registry, a total of 159 patients including 339 coronary lesions with intermediate stenosis were included. All patients underwent coronary CTA before being referred for coronary angiography and both FFR measurement and OCT examination were performed during angiography. The stenotic lesion with FFR ≤0.80 was considered diagnostic of lesion causing ischemia. The predictive value of plaque characteristics assessed by coronary CTA and OCT for identifying lesions causing ischemia was analyzed. Results Stenosis severity and plaque characteristics on coronary CTA and OCT were different between the lesions causing ischemia versus not causing ischemia. On multivariate analysis, low attenuation plaque on coronary CTA (odds ratio OR= 2.78; P=0.038) and thrombus (OR=5.13; 0.042), plaque rupture (OR=3.25; P=0.017), and intimal vasculature on OCT (OR=2.57; P=0.012) were independent predictors for the lesions causing ischemia. Increasing number of these plaque characteristics offered incremental improvement in predicting the lesions causing ischemia. Conclusions Comprehensive anatomical evaluation of coronary stenosis may be able to provide additional supportive information for predicting the lesions causing ischemia.
Park et al. (Tue,) conducted a observational in Intermediate coronary stenosis (n=159). Coronary CTA and OCT was evaluated on Lesions causing ischemia (FFR ≤0.80) (OR 2.78, 5.13, 3.25, 2.57, p=0.038, 0.042, 0.017, 0.012). Low attenuation plaque on CTA (OR 2.78) and thrombus (OR 5.13), plaque rupture (OR 3.25), and intimal vasculature on OCT (OR 2.57) independently predicted ischemia-causing lesions (FFR ≤0.80).