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Predictive value of the QFR in detecting vulnerable plaques in non-flow limiting lesions: a combined analysis of the PROSPECT and IBIS-4 study.
Safi, Hannah; Bourantas, Christos V; Ramasamy, Anantharaman; Zanchin, Thomas; Bär, Sarah; Tufaro, Vincenzo; Jin, Chongying; Torii, Ryo; Karagiannis, Alexios; Reiber, Johan H C; Mathur, Anthony; Onuma, Yoshinubo; Windecker, Stephan; Lansky, Alexandra; Maehara, Akiko; Serruys, Patrick W; Stone, Peter; Baumbach, Andreas; Stone, Gregg W; Räber, Lorenz.
Afiliación
  • Safi H; Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK.
  • Bourantas CV; Institute of Cardiovascular Sciences, University College London, London, UK.
  • Ramasamy A; Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK. cbourantas@gmail.com.
  • Zanchin T; Institute of Cardiovascular Sciences, University College London, London, UK. cbourantas@gmail.com.
  • Bär S; William Harvey Research Institute, Queen Mary University London, London, UK. cbourantas@gmail.com.
  • Tufaro V; Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK.
  • Jin C; William Harvey Research Institute, Queen Mary University London, London, UK.
  • Torii R; Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK.
  • Karagiannis A; Department of Cardiology, Bern University Hospital, Bern, Switzerland.
  • Reiber JHC; Department of Cardiology, Bern University Hospital, Bern, Switzerland.
  • Mathur A; Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK.
  • Onuma Y; Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK.
  • Windecker S; Department of Cardiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
  • Lansky A; Department of Mechanical Engineering, University College London, London, UK.
  • Maehara A; CTU Bern, Institute of Social and Preventive Medicine, Bern University, Bern, Switzerland.
  • Serruys PW; Medis Medical Imaging Systems bv, Leiden, The Netherlands.
  • Stone P; Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK.
  • Baumbach A; William Harvey Research Institute, Queen Mary University London, London, UK.
  • Stone GW; Department of Interventional Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
  • Räber L; Department of Cardiology, Bern University Hospital, Bern, Switzerland.
Int J Cardiovasc Imaging ; 36(6): 993-1002, 2020 Jun.
Article en En | MEDLINE | ID: mdl-32152810
Studies have shown that the quantitative flow ratio (QFR), recently introduced to assess lesion severity from coronary angiography, provides useful prognostic information; however the additive value of this technique over intravascular imaging in detecting lesions that are likely to cause events is yet unclear. We analysed data acquired in the PROSPECT and IBIS-4 studies, in particular the baseline virtual histology-intravascular ultrasound (VH-IVUS) and angiographic data from 17 non-culprit lesions with a presumable vulnerable phenotype (i.e., thin or thick cap fibroatheroma) that caused major adverse cardiac events or required revascularization (MACE) at 5-year follow-up and from a group of 78 vulnerable plaques that remained quiescent. The segments studied by VH-IVUS were identified in coronary angiography and the QFR was estimated. The additive value of 3-dimensional quantitative coronary angiography (3D-QCA) and of the QFR in predicting MACE at 5 year follow-up beyond plaque characteristics was examined. It was found that MACE lesions had a greater plaque burden (PB) and smaller minimum lumen area (MLA) on VH-IVUS, a longer length and a smaller minimum lumen diameter (MLD) on 3D-QCA and a lower QFR compared with lesions that remained quiescent. By univariate analysis MLA, PB, MLD, lesion length on 3D-QCA and QFR were predictors of MACE. In multivariate analysis a low but normal QFR (> 0.80 to < 0.97) was the only independent prediction of MACE (HR 3.53, 95% CI 1.16-10.75; P = 0.027). In non-flow limiting lesions with a vulnerable phenotype, QFR may provide additional prognostic information beyond plaque morphology for predicting MACE throughout 5 years.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Angiografía Coronaria / Ultrasonografía Intervencional / Circulación Coronaria / Vasos Coronarios / Placa Aterosclerótica Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Int J Cardiovasc Imaging Asunto de la revista: DIAGNOSTICO POR IMAGEM Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Angiografía Coronaria / Ultrasonografía Intervencional / Circulación Coronaria / Vasos Coronarios / Placa Aterosclerótica Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Int J Cardiovasc Imaging Asunto de la revista: DIAGNOSTICO POR IMAGEM Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos