Coronary disease & ACSCase-control study
Anatomical vs Physiological Lesion Characteristics in Prediction of Acute Coronary Syndrome
- Case-control study
- international
- multicentre
- internal case-control
- core lab coronary computed tomography angiography (CCTA) analyses
- Median interval to acute coronary syndrome (ACS) 375 [95.0-644.5] days
Authors' conclusion
Luminal narrowing, plaque quality and quantity, and local hemodynamics were independent predictors of ACS, offering specificity in physiology and sensitivity in anatomy. A comprehensive assessment of them further refined the risk prediction for future ACS.
Study context
- Population
- ACS patients who underwent coronary CT angiography 1 month to 3 years before the event
- Participants
- 351 patients · 2,451 lesions
- Comparison
- ΔFFRCT vs Combined anatomy
- Outcome
- Diagnostic performance in identifying ACS culprit lesions
Main finding
As reported in the abstract
Identification of ACS culprit lesions
| Group | Sensitivity (highest) | Specificity (highest) | AUC |
|---|---|---|---|
| Plaque burden ≥70% | 90.6% (87.2%-93.2%) | ||
| ΔFFRCT ≥0.10 | 88.3% (86.9%-89.6%) | ||
| ΔFFRCT | 0.805 [0.782-0.829] | ||
| Combined anatomy | 0.802 [0.777-0.826] |
- ΔFFRCT vs Combined anatomy: P = 0.748 — similar predictability, with additive discrimination towards each other
- Lesions that became ACS culprits
- 363 (14.8%)
- All anatomical and simulated physiological characteristics independently associated with culprit lesions
- all P < 0.001
Observational data: associations, not effects.
Original publication
Anatomical vs Physiological Lesion Characteristics in Prediction of Acute Coronary Syndrome. JACC Cardiovasc Interv. Published 8 December 2025. doi:10.1016/j.jcin.2025.09.006
Summarised from the published abstract; every number is checked against it