Coronary CT angiography-derived plaque characteristics and physiologic patterns for peri-procedural myocardial infarction and subsequent events
Authors' conclusion
Coronary CTA can evaluate plaque characteristics and physiologic disease patterns simultaneously, which plays an important role for risk stratification before PCI.
Study context
- Population
- Patients with normal pre-PCI high-sensitivity cardiac troponin T (hs-cTnT) undergoing coronary computed tomography angiography (CTA) before percutaneous coronary intervention (PCI)
- Participants
- 359 patients
- Exposure
- ≥3 high-risk plaque characteristics (HRPC) and low FFRCT PPG on coronary CTA vs other plaque/physiologic patterns
- Outcome
- PMI (hs-cTnT >5 times upper limit of normal after PCI) and MACE (cardiac death, spontaneous MI, target vessel revascularization)
Main finding
As reported in the abstract
PMI (independent predictors)
Odds ratio (95% CI)P value
≥3 HRPC in target lesions
2.21(1.29–3.80)
P = 0.004Low FFRCT PPG
1.23(1.02–1.52)
P = 0.028Observational data: associations, not effects.
Further findings
| Outcome | Values | Estimate | P value |
|---|---|---|---|
| MACE by four-group classification (HRPC and FFRCT PPG) | ≥3 HRPC and low FFRCT PPG 19.3% | ||
| Incremental prognostic value for MACE vs clinical risk factors aloneModel with ≥3 HRPC and low FFRCT PPG vs Clinical risk factors alone | C index 0.78 vs. 0.60 | P = 0.005 | |
| Incremental prognostic value for MACE vs clinical risk factors aloneModel with ≥3 HRPC and low FFRCT PPG vs Clinical risk factors alone | net reclassification index 0.21 (95% CI 0.04–0.48) | P = 0.020 |
- Major adverse cardiovascular events (MACE) by four-group classification (HRPC and FFRCT PPG) — Highest MACE risk with ≥3 HRPC and low FFRCT PPG
- overall P = 0.001
MACE by four-group classification (HRPC and FFRCT PPG)
- ≥3 HRPC and low FFRCT PPG an independent predictor of MACE
Original publication
Coronary CT angiography-derived plaque characteristics and physiologic patterns for peri-procedural myocardial infarction and subsequent events. Eur Heart J Cardiovasc Imaging. Published 20 February 2023. doi:10.
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