Coronary disease & ACSCase-control study
Association of Hemodynamic Disease Severity and Distribution With Risk of Future Acute Coronary Syndrome
- Case-control study
- international
- multicenter
- internal case-control
Authors' conclusion
Hemodynamic disease distribution, as measured by PPGCT, complements FFRCT in predicting ACS risk.
Study context
- Population
- Patients with acute coronary syndrome (ACS) who underwent coronary CT angiography 1 month to 3 years before the event
- Participants
- 351 patients · 873 vessels
- Comparison
- Hemodynamic disease patterns in ACS culprit vs nonculprit vessels
- Outcome
- ACS culprit vessel (prognostic significance of hemodynamic disease severity and distribution)
Main finding
As reported in the abstract
ACS risk
Estimate (95% CI)P value
FFRCTper 0.1 increase in FFRCT
OR 0.71(0.65–0.77)
P < 0.001PPGCTper 0.1 increase in PPG
OR 1.22(1.09–1.37)
P < 0.001Focal diseasehighest risk among the 4 patterns
RR 2.02(1.74–2.36)
P < 0.001Each row per its own increment, as printed
Observational data: associations, not effects.
Further findings
MI and unstable angina, focal disease
| Comparison | RR (95% CI) | P value | |
|---|---|---|---|
| Focal disease · MI | 1.75 (1.43–2.14) | P < 0.001 | |
| Focal disease · unstable angina | 2.54 (2.00–3.22) | P < 0.001 | |
| 0.20.5125Relative risk (log scale) |
ACS, focal disease, by lesion subgroup
| Comparison | OR (95% CI) | P value | |
|---|---|---|---|
| Focal disease · nonobstructive lesions | 3.56 (1.43–8.84) | ||
| Focal disease · obstructive lesions | 3.16 (1.96–5.07) | ||
| Focal disease · non-HRP | 6.69 (3.59–12.5) | ||
| Focal disease · HRP | 2.98 (1.83–4.87) | ||
| 0.050.21520Odds ratio (log scale) |
Vessel-level FFRCT and PPGCT
- Mean FFRCT
- 0.74 ± 0.17
- Mean PPGCT
- 0.54 ± 0.14
Maximal lesion-level ΔFFRCT
- Maximal ΔFFRCT showed superior model performance vs models with FFRCT and PPGCT; higher PPGCT additionally associated with increased ACS risk, particularly with maximal ΔFFRCT ≥0.10
Original publication
Association of Hemodynamic Disease Severity and Distribution With Risk of Future Acute Coronary Syndrome. JACC Cardiovasc Imaging. Published 6 July 2026. doi:10.1016/j.jcmg.2026.05.012
Summarised from the published abstract; every number is checked against it