Long-term outcomes of patients with normal fractional flow reserve and thin-cap fibroatheroma
Authors' conclusion
OCT-detected TCFA-positive lesions, although not ischaemia-generating, are associated with an increased risk of adverse events during long-term follow-up.
Study context
- Population
- Patients with diabetes mellitus (DM) and ≥1 fractional flow reserve (FFR)-negative lesion
- Participants
- 390 patients
- Exposure
- Thin-cap fibroatheromas (TCFA)-positive vs TCFA-negative patients
- TCFA-positiven = 98
- TCFA-negativen = 292reference
- Outcome
- Composite of:
- Cardiac mortality
- Target vessel-related MI
- Clinically driven target lesion revascularisation (TLR)
- Unstable angina requiring hospitalisation
- Follow-up
- Up to 5 years
Methodological detailsinternational, double-blind
- International
- Double-blind
Main finding
As reported in the abstract
TCFA-positive vs TCFA-negativeEstimate (95% CI)P value
TCFA-positive
HR 2.89(1.61–5.20)
P < 0.001Rate ratio
RR 2.61(1.38–4.90)
P = 0.002Observational data: associations, not effects.
Further findings
Events per 100 patient-years
| Outcome | TCFA-positive | TCFA-negative | Estimate | P value | |
|---|---|---|---|---|---|
| Recurrent events (TV-MI, TLR, UA as recurrent PE components) | 13.45 | 2.87 | HR 2.89 (95% CI 1.74–4.80) | P < 0.001 | |
| Recurrent events (TV-MI, TLR, UA as recurrent PE components)Rate ratio | RR 4.69 (95% CI 2.86–7.83) | P < 0.001 | |||
| TCFA as independent predictor of PE (multivariable)Multivariable analysis | HR 2.76 (95% CI 1.53–4.97) | P < 0.001 | |||
| 0.10.31310Ratio (log scale) |
Original publication
Long-term outcomes of patients with normal fractional flow reserve and thin-cap fibroatheroma. EuroIntervention. Published 6 February 2023. doi:10.
Summarised from the published abstract; every number is checked against it