C-10 | Comparison of Two-Dimensional Quantitative Coronary Angiography (2D-QCA) With Optical Coherence Tomography in the Assesssment of Coronary Artery Lesion Dimensions and Calcium Detection

Our study aimed to describe the correlation between an extended and comprehensive set of OCT measurements and the two-dimensional quantitative coronary angiography in the assessment of coronary artery lesion dimensions and calcification A Prospective observational study was conducted on patients who were admitted in Apollo BGS Hospital, Mysore with coronary artery disease, undergoing OCT for various clinical indications. Simultaneous 2D-QCA and OCT were performed to look for Proximal, distal, and minimum luminal diameter (MLD). Coronary artery calcification was scored semi quantitatively by Yamanaka's method on invasive coronary angiography (ICA). On OCT the lesion were classified based on maximum calcium length, thickness and arc. A total of 102 patients were studied out of which eight patients were excluded based on exclusion criteria (N=94). There was good correlation for proximal and distal reference diameter. However, the MLD by QCA was significantly smaller (95% CI) than OCT suggesting a poor agreement for MLD. The ICA detected fewer calcified plaque lesions compared to OCT (N=72; 76.5%). All Cases of positive ICA were detected by OCT while severity of calcium significantly differed. There is a good Correlation and agreement between QCA and OCT for the measurement of proximal and distal reference diameter. However, the MLD was underestimated by QCA. Compared to OCT the ICA has a low sensitivity to detect calcified plaques. The OCT offers detailed information on calcium assessment to shed light on the use of dedicated calcium debulking therapies for lesion preparation and better outcome.