Author + information
- Mariusz Tomaniak1,
- Janusz Kochman1,
- Lukasz Koltowski2,
- Dorota Ochijewicz3,
- Arkadiusz Pietrasik1,
- Jacek Jakala4,
- Klaudia Proniewska5,
- Krzysztof Malinowski5 and
- Grzegorz Opolski1
- 11st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
- 21st Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
- 3Medical University of Warsaw, 1st Department of Cardiology, Warsaw, Poland
- 4University Hospital, Krakow, Poland
- 5Krakow Cardiovascular Research Institute, Krakow, Poland
Optical coherence tomography (OCT) might allow to identify lesion features reportedly increasing plaque vulnerability and subsequent risk of adverse clinical events. However, still limited data are available on the association between the functional relevance of coronary artery stenosis assessed by fractional flow reserve (FFR) and OCT-derived lesion parameters. The aim of this study was to compare plaque morphology in haemodynamically relevant vs. not relevant lesions by FFR using OCT.
Consecutive patients with intermediate grade coronary stenoses by angiography were evaluated by both FFR and OCT in this single-centre study. Stenoses were labelled hemodynamically relevant in case of the FFR ≤ 0.80. Minimal lumen area (MLA), fibrous cap thickness (FCT), minimal cap thickness over the calcium, angle of the calcium and necrotic core within the lesions were evaluated. Analyses were performed by independent core laboratory.
A total of 124 patients (124 lesions) were analyzed. There were 67 (54.0%) coronary artery lesions identified as hemodynamically relevant by FFR. Lesions with FFR ≤ 0.80 presented with lower MLA (1.84 ± 0.95 vs. 2.58 ± 1.3, p = 0.001) and higher maximal angle of the calcium (141.11 ± 78.87° vs. 113.07 ± 71.20°, p = 0.038) compared to patients with FFR > 0.80. No differences were found between groups in the mean (0.15 ± 0.05 mm vs. 0.14 ± 0.05 mm, p = 0.533) and minimal FCT (0.14 ± 0.05 mm vs. 0.13 ± 0.05 mm, p = 0.330), mean (116.10 ± 36.45° vs. 104.48 ± 39.31°, p = 0.212) and maximal necrotic core angle (148.38 ± 72.18° vs. 114.35 ± 41.57°; p = 0.252) as well as minimal cap thickness over the calcium (0.09 ± 0.07mm vs. 0.10 ± 0.07mm, p = 0.827). Overall, in haemodynamically relevant and not relevant stenoses similar rate of calcified (35.8% vs. 38.6%, p = 0.736) and lipid plaques (38.8% vs. 29.8%, p = 0.286) was revealed.
Although haemodynamic relevance of intermediate grade lesions correlated strongly with the luminal assessment and the extent of calcification, no differences were identified in other OCT lesion parameters between relevant and not relevant coronary stenoses by FFR.
IMAGING: Imaging: Intravascular