Key result
Greater plaque burden and diameter stenosis are inversely associated with vessel-specific FFRCT values.
Why the study?
Coronary computed tomography angiography-derived fractional flow reserve (FFRCT) accurately diagnoses ischemic intermediate stenosis, but its significant determinants have not been fully evaluated.
Are CCTA-derived plaque volume, morphology, and clinical biomarkers associated with FFRCT in diabetic patients with intermediate coronary artery stenosis?
Cross-Sectional (n=39)
Blinded core laboratory analysis
Yes
Are CCTA-derived plaque volume, morphology, and clinical biomarkers associated with FFRCT in diabetic patients with intermediate coronary artery stenosis?
In diabetic patients with intermediate coronary stenosis, CCTA-derived atheroma volume, non-calcified plaque morphology (especially in the LAD), and glycemic control (HbA1c) are significant determinants of functional ischemia assessed by FFRCT.
Answers are grounded in this paper and cite their sources.
Atheroma volume and stenosis associate with lower FFRCT in diabetic intermediate lesions; leaves open whether volumetric CCTA metrics refine ischemia assessment.
Aim Coronary computed tomography angiography (CCTA)-derived fractional flow reserve (FFRCT) accurately diagnoses ischemic lesions of intermediate stenosis severity. However, significant determinants of FFRCT have not been fully evaluated. Methods This was a sub-analysis of the Treatment of Alogliptin on Coronary Atherosclerosis Evaluated by Computed Tomography-Based Fractional Flow Reserve trial. Thirty-nine diabetic patients (117 vessels) with intermediate coronary artery stenosis [percent diameter stenosis (%DS) ＜70%] in whom FFRCT was measured were included in this study. CCTA-defined, vessel-based volumetric and morphological characteristics of plaques were examined to determine their ability to predict FFRCT. Results Patient-based, multivariate linear regression analysis showed that hemoglobinA1c, triglycerides, and the estimated glomerular filtration rate were significant independent factors associated with FFRCT. Vessel-based, univariate linear regression analysis showed that the total atheroma volume (r=－0.233, p=0.01) and the percentage atheroma volume (PAV) (r=－0.284, p=0.002) as well as %DS (r=－0.316, p=0.006) were significant determinants of FFRCT. Among the plaque components, significant negative correlations were observed between FFRCT and low- (r=－0.248, p=0.007) or intermediate-attenuation plaque volume (r=－0.186, p=0.045), whereas calcified plaque volume was not associated with FFRCT. In the left anterior descending coronary artery (LAD), the plaque volume of each component was associated with FFRCT. Conclusions Plaque volume, PAV, and %DS were significant determinants of FFRCT. Plaque morphology, particularly in LAD, was associated with FFRCT in diabetic patients with intermediate coronary artery stenosis.
No takes yet. Share an insight, caveat, or question.
Nozue et al. (2018) conducted a cross-sectional in Type 2 diabetes with intermediate coronary artery stenosis (%DS <70%) (n=39). CCTA-defined plaque volume, percentage atheroma volume (PAV), and plaque morphology was evaluated on Coronary computed tomography angiography-derived fractional flow reserve (FFRCT) (r = -0.284 (for PAV), p=0.002). Total atheroma volume (r=-0.233, p=0.01), percentage atheroma volume (r=-0.284, p=0.002), and percent diameter stenosis (r=-0.316, p=0.006) were significant negative determinants of FFRCT.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: