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- W2954298723 abstract "Background: High-risk plaque (HRP) characteristics such as low attenuation plaque (LAP), positive remodelling and spotty calcification are feasibly identified on computed tomography coronary angiography (CTCA). The presence of ≥2HRP are considered very high-risk with a strong independent association with prognosis. Fractional Flow Reserve (FFR) however, remains the reference standard for lesion-level coronary intervention in stable patients. Purpose: We investigated the relationship between qualitative HRP (non-invasive anatomical assessment) and FFR (invasive functional assessment). Methods: Consecutive stable coronary artery disease patients who underwent CTCA and invasive FFR at MonashHeart between 2009–2017 were reviewed. Patients with significant FFR (<0.8) were propensity-matched for age, sex and cardiovascular risk factors to patients with non-significant FFR resulting in 55 patients per group. Logistic regression analysis was applied to define predictors of FFR significance. Odds ratios (OR) with respective 95% confidence intervals are reported. Results: The presence of a single HRP feature in a lesion was similar between FFR significant vs non-significant (78% vs 72%, p = 0.66). The presence of ≥2 HRP features in a lesion was greater in FFR significant vessels (51% vs 25%, p = 0.01). Univariable predictors of FFR-significance included increasing total plaque burden (p = 0.002), increasing minimal luminal area (p = 0.002), ≥2HRP features (p = 0.007), and presence of LAP (p = 0.05). On multivariable assessment, total plaque burden (Odds Ratio (OR 1.06 (1.01–1.11), p = 0.01), decreasing minimal luminal area (OR 0.54 (0.41–0.81), p = 0.001), and ≥2HRP (OR 3.91 (1.43–10.71), p = 0.008) remained independent predictors of significant invasive FFR. Conclusions: The presence of ≥2 HRP features within a coronary lesion non-invasively identified on CTCA independently predict FFR significance." @default.
- W2954298723 created "2019-07-12" @default.
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- W2954298723 date "2019-01-01" @default.
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- W2954298723 title "Computed Tomography Coronary Angiography Derived High Risk Plaques Predict Physiological Significance of Coronary Artery Stenoses as Assessed with Invasive Fractional Flow Reserve" @default.
- W2954298723 doi "https://doi.org/10.1016/j.hlc.2019.06.258" @default.
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