Additional prognostic impact of plaque characterization with on-site CT-derived fractional flow reserve in coronary CT angiography.
J Cardiol
; 84(5): 336-341, 2024 Nov.
Article
em En
| MEDLINE
| ID: mdl-38876399
ABSTRACT
BACKGROUND:
On-site computed tomography-derived fractional flow reserve (CT-FFR) is a feasible method for examining lesion-specific ischemia, and plaque analysis of coronary CT angiography (CCTA) is useful for predicting future cardiac events. However, their utility and association on a per-vessel level remain unclear.METHODS:
We analyzed vessels showing 50-90â¯% stenosis on CCTA where planned revascularization was not performed after CCTA within 90â¯days. Relevant features, including CT-FFR and the plaque burden [necrotic core to the total plaque volume (% necrotic core), and non-calcified plaque (NCP) to vessel volume (% NCP)] using a novel algorithm for analyzing plaque to predict vessel-oriented composite outcomes (VOCO), including cardiac death, non-fatal myocardial infarction, and unplanned vessel-related revascularization, were assessed.RESULTS:
In 256 patients (68.7⯱â¯9.4â¯years; 73.8â¯% male) with 354 vessels (10.5â¯% CT-FFRâ¯≤â¯0.80), VOCO occurred in 24 vessels (6.8â¯%) during a median follow-up of 3.6â¯years. Multivariable Cox analysis revealed CT-FFRâ¯≤â¯0.80 had the pronounced impact on VOCO, and moreover, higher % necrotic core and % NCP were independently associated with VOCO [adjusted hazard ratio 3.43 (95â¯% confidence interval 1.42-8.29) and 4.05 (1.19-13.71), respectively], especially for vessels with CT-FFRâ¯>â¯0.80.CONCLUSIONS:
In vessels without planned revascularization, per-vessel CT-FFRâ¯≤â¯0.80 was the notable predictor of future cardiac events. Additionally, necrotic core volume and NCP were identified as independent predictors along with CT-FFR.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article