Additive diagnostic value of atherosclerotic plaque characteristics to non-invasive FFR for identification of lesions causing ischaemia: results from a prospective international multicentre trial

EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
Ryo NakazatoJames K Min

Abstract

We evaluated the association between atherosclerotic plaque characteristics (APCs) by CT -including positive remodelling (PR), low attenuation plaque (LAP) and spotty calcification (SC)- and lesion ischaemia by fractional flow reserve (FFR). Two hundred and fifty-two patients (17 centres, five countries) underwent CT, FFR derived from CT (FFRCT) with invasive FFR performed for 407 coronary lesions. FFR ≤0.8 was indicative of lesion-specific ischaemia. CT diameter ≥50% stenosis was considered obstructive. APCs by CT were defined as: (1) PR, lesion diameter/reference diameter >1.10; (2) LAP, any voxel <30 HU; and (3) SC, nodular calcified plaque <3 mm. Odds ratios (OR) and area under the ROC curve (AUC) of APCs for lesion-specific ischaemia were analysed. PR, LAP and SC were associated with ischaemia, with a three to fivefold higher prevalence than in non-ischaemic lesions. Among individual APC, PR (OR 4.7, p<0.001), but not SC or LAP, was strongly associated with lesion-specific ischaemia and provided incremental prediction for lesion-specific ischaemia over CT stenosis plus FFRCT (AUC 0.87 vs. 0.83, p=0.002). APCs' features -especially PR- by CT improve identification and reclassification of coronary lesions which cause ischaem...Continue Reading

References

Jun 27, 1996·The New England Journal of Medicine·N H PijlsJ J Koolen
May 10, 2007·JAMA : the Journal of the American Medical Association·Paul ErneMatthias Pfisterer
Jul 31, 2007·Journal of the American College of Cardiology·Sadako MotoyamaJagat Narula
Jan 16, 2009·The New England Journal of Medicine·Pim A L ToninoUNKNOWN FAME Study Investigators
Mar 11, 2009·Journal of Cardiovascular Computed Tomography·Gilbert L RaffUNKNOWN Society of Cardiovascular Computed Tomography
Jun 27, 2009·Journal of the American College of Cardiology·Sadako MotoyamaJagat Narula
Mar 6, 2010·Journal of the American College of Cardiology·James K MinDaniel S Berman
Jan 5, 2011·Statistics in Medicine·Michael J PencinaEwout W Steyerberg
Jan 21, 2011·The New England Journal of Medicine·Gregg W StoneUNKNOWN PROSPECT Investigators
Aug 28, 2012·JAMA : the Journal of the American Medical Association·James K MinLaura Mauri
Jan 29, 2013·Journal of the American College of Cardiology·Ron WaksmanRebecca Torguson

❮ Previous
Next ❯

Citations

Jun 29, 2017·European Journal of Clinical Investigation·Konstantin KazankovHendrik Vilstrup
Jun 20, 2018·Circulation. Cardiovascular Imaging·James K Min
Oct 10, 2019·British Journal of Pharmacology·Marwa Daghem, David E Newby
Dec 12, 2018·BioMed Research International·Nazario CarrabbaRenato Valenti
Oct 12, 2018·BioMed Research International·Patrizia CaritàGianluca Pontone
Jan 31, 2020·Yonsei Medical Journal·Hyung Bok ParkHyuk Jae Chang
Aug 20, 2019·JACC. Cardiovascular Imaging·Armin Arbab-Zadeh

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atherosclerosis Disease Progression

Atherosclerosis is the buildup of plaque on artery walls, causing stenosis which can eventually lead to clinically apparent cardiovascular disease. Find the latest research on atherosclerosis disease progression here.

Related Papers

© 2021 Meta ULC. All rights reserved