Atherosclerotic Lesion, Coronary Artery Disease Progression, Optical Coherence Tomography, Radial Wall Strain
Conditions
Brief summary
The present study sought to explore the predictive value of radial wall strain (RWS, derived solely from angiograms) for coronary artery lesion progression compared with lesion vulnerability assessed by optical coherence tomography (OCT). The lesion progression at 1 year was defined as an increase of ≥20% in diameter stenosis based on quantitative coronary angiography (QCA) evaluation.
Detailed description
The recently developed angiography-derived maximum RWS (RWSmax) was computed as the maximum deformation of lumen diameter throughout the cardiac cycle, expressed as a percentage of the largest lumen diameter. This approach offers a quantitative assessment of the biomechanical attributes of coronary lesions. Consequently, it allows for the identification of lesion vulnerability, potentially compensating for the limitations of intravascular imaging in assessing lesion stability and optimizing strategies for identifying high-risk vulnerable plaques in patients. In the present multicenter, prospective cohort of individuals with acute myocardial infarction, we assessed the predictive significance of identifying vulnerable lesions using an RWSmax threshold of ≥13%. The investigation aimed to determine the capacity of these identified lesions to predict the progression of the disease at 1 year. Furthermore, the study validated that predictive capacity of RWSmax was on par with, and not inferior to, lesion vulnerability assessed by OCT in tracking lesion progression.
Interventions
None listed
Sponsors
China National Center for Cardiovascular Diseases
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* General Inclusion Criteria: 1. Age ≥18 years 2. Acute myocardial infarction ≤ 45 days 3. Planned coronary angiography examination or potential interventional treatment * Angiographic Inclusion Criteria: 1. The presence of at least 1 non-flow-restricting lesion (visually estimated diameter stenosis: 30%-80%; QFR \> 0.80) in any non-infarct related artery with RVD ≥2.5 mm by visual assessment
Exclusion criteria
* General
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Lesion progression assessed by QCA | 1 year | Defined as an increase of ≥20% in diameter stenosis based on QCA evaluation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of all-cause death | 1 year, 2 years, 3 years | Including cardiac or non-cardiac death |
| Incidence of new myocardial infarction | 1 year, 2 years, 3 years | — |
| Incidence of unplanned revascularization | 1 year, 2 years, 3 years | Including infarction-related/non-infarction-related vessel revascularization |
| Incidence of stent thrombosis | 1 year, 2 years, 3 years | Including probable and definite stent thrombosis |
| μQFR | 1 year | Angiography-derived FFR |
| RWSmax, % | 1 year | Angiography-derived radial wall strain |
| Incidence of major adverse cardiac events (MACE) | 1 year, 2 years, 3 years | Defined as a composite endpoint of all-cause death, new myocardial infarction, and unplanned revascularization |
| Minimal fibrous cap thickness (FCTmin), mm | 1 year | Measured by OCT |
| Lipid arc, ° | 1 year | Measured by OCT |
| Plaque burden, % | 1 year | Measured by OCT |
| Index of plaque attenuation (IPA) | 1 year | Measured by OCT |
| Virtual flow ratio (VFR) | 1 year | Measured by OCT |
| Diameter stenosis by QCA, % | 1 year | Measured by QCA |
Countries
China
Contacts
Primary ContactLei Song, MD
Outcome results
None listed