Key result
High radial wall strain is linked to ~582% increased risk of coronary lesion progression.
Why the study?
Intermediate coronary lesions carry a mixed prognosis, and the role of radial strain in predicting lesion progression remains largely unknown.
Does angiography-derived radial wall strain predict coronary lesion progression in patients with untreated non-culprit intermediate coronary lesions?
Cohort (n=603)
Blinded analysts
No
Does angiography-derived radial wall strain predict coronary lesion progression in patients with untreated non-culprit intermediate coronary lesions?
Angiography-derived radial wall strain is a feasible tool that provides independent prognostic value for predicting the progression of untreated intermediate coronary lesions.
May refine progression risk stratification in intermediate lesions; hypothesis-generating pending prospective validation.
BACKGROUND: Intermediate coronary lesions (ICLs) are highly prevalent but ported mixed prognosis. Radial strain has been associated with plaque vulnerability, yet its role in predicting lesion progression is largely unknown. The purpose of this study was to determine the predictive value of angiography-derived radial wall strain (RWS) for progression of untreated non-culprit ICLs. METHODS: analysis was conducted in a study cohort including 603 consecutive patients with 808 ICLs identified at index procedure with angiographic follow-up of up to two years. RWS analysis was performed on selected angiographic frames with minimal foreshortening and vessel overlap. Lesion progression was defined as ≥ 20% increase in percent diameter stenosis. CONCLUSIONS: Assessment of RWS from coronary angiography is feasible and provides independent prognostic value in patients with untreated ICLs.
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Wang et al. (2022) conducted a cohort in Untreated non-culprit intermediate coronary lesions (n=603). Maximal radial wall strain (RWSmax) > 12.6% vs. RWSmax ≤ 12.6% was evaluated on Angiographic lesion progression (≥ 20% increase in percent diameter stenosis) (adjusted HR 6.82, 95% CI 3.67-12.66, p=< 0.001). Exposure to a high strain amplitude with maximal radial wall strain > 12.6% was independently associated with an increased risk of coronary lesion progression (adjusted HR 6.82).
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