Coronary disease & ACSCohort study

Fractional Flow Reserve–Negative High-Risk Plaques and Clinical Outcomes After Myocardial Infarction

JAMA CardiolPublished

  • Prospective cohort study
  • international
  • multicentre
  • observational

Authors' conclusion

Among patients with MI and FFR-negative nonculprit lesions, the presence of a high-risk plaque is associated with a worse clinical outcome, which is mainly driven by a higher number of unplanned revascularizations.

Study context

Population
Patients with myocardial infarction (MI) (STEMI or NSTEMI) with fractional flow reserve (FFR)-negative (FFR > 0.80) nonculprit lesions imaged by optical coherence tomography (OCT)420 with analysable OCT
Participants
438 patients
Exposure
High-risk plaque vs No high-risk plaque
  • High-risk plaquen = 143
  • No high-risk plaquen = 277reference
Outcome
Major adverse cardiovascular events (MACE):
  • All-cause mortality
  • Nonfatal MI
  • Unplanned revascularization
Follow-up
2-year follow-up

Main finding

As reported in the abstract

Hazard ratio

1.93

95% CI 1.08–3.47

P = 0.02

Events by group

High-risk plaque vs No high-risk plaque
HR 1.93 (95% CI 1.08–3.47); P = 0.02

Observational data: associations, not effects.

Further findings

Unplanned revascularization

P = 0.02

Original publication

Fractional Flow Reserve–Negative High-Risk Plaques and Clinical Outcomes After Myocardial Infarction. JAMA Cardiol. Published 1 November 2023. doi:10.1001/jamacardio.2023.2910

Summarised from the published abstract; every number is checked against it