Impact of clinical risk characteristics on the prognostic value of high-risk plaques
Authors' conclusion
HRPs are associated with a negative clinical outcome, without apparent differences between clinical risk profiles.
Study context
- Population
- Patients in the COMBINE (OCT-FFR) and PECTUS-obs studies assessed for high-risk coronary plaques
- Participants
- 810 patients
- Comparison
- HRP vs no HRP across clinical risk profiles
- Low riskn = 311
- Intermediate riskn = 265
- High riskn = 234
- Outcome
- MACE (patient level) and TLF (lesion level) by HRP across clinical risk profiles
Methodological detailsCOMBINE (OCT-FFR) and PECTUS-obs
- COMBINE (OCT-FFR) and PECTUS-obs
Pooled result
As reported in the abstract
Worse outcome with HRP across risk profiles
- Consistent trend towards worse clinical outcome with HRP across clinical risk profiles
- Interaction P=0.539 for major adverse cardiovascular events (MACE)
- Interaction P=0.337 for target lesion failure (TLF)
Further pooled results
Discrimination of modified TRS-2P for HRP
- AUC (95% CI 0.47-0.56); no discriminative value
- 0.51
TLF in high-risk patients with HRP
- Event rate per 100 lesion-years (95% CI 3.52-10.36); highest
- 6.28
- Absolute risk at 2 years
- 13.6%
Original publication
Impact of clinical risk characteristics on the prognostic value of high-risk plaques. EuroIntervention. Published 6 October 2025. doi:10.
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