Long-Term Prognostic Impact of OCT-Derived High-Risk Plaque Features: Extended Follow-Up of the CLIMA Study
Main findingResult — go to the resultAdjusted hazard ratio 4.33 95% CI 2.01–9.33Authors' conclusion
The simultaneous presence of 4 OCT high-risk features, although infrequent, was independently associated with cardiac death or TS-MI on long-term follow-up. The presence of any TCFA was 5-fold as prevalent and similarly predictive of 5-year adverse outcomes.
Study context
- Population
- Patients undergoing optical coherence tomographic (OCT) of the untreated proximal left anterior descending coronary artery (CLIMA study)
- Participants
- 1,003 patients
- Exposure
- All 4 OCT high-risk criteria vs not all 4
- Outcome
- Cardiac death or target segment MI (TS-MI)
- Follow-up
- 5 years
Methodological detailsmulticentre, international
- Multicentre
- International
Main finding
As reported in the abstract
5-year follow-up (median 1,825 days; Q1-Q3: 1,137-1,825 days)
Adjusted hazard ratio
4.33
95% CI 2.01–9.33
By group
All 4 OCT criteria
3.6%
All 4 OCT criteriavs Without all 4 OCT criteria
adjusted HR 4.33 (95% CI 2.01–9.33)
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | |
|---|---|---|
| Cardiac death | HR 3.73 (95% CI 1.59–8.73) | |
| TS-MI | HR 7.02 (95% CI 2.37–20.77) | |
| Primary endpoint, adjusted for high-intensity lipid-lowering therapy | adjusted HR 2.94 (95% CI 1.21–7.11) | |
| 0.050.21520Ratio (log scale) |
Any thin-cap fibroatheroma (TCFA)
- Any TCFA prevalence
- 18.3%
- Similarly predictive of cardiac death and/or target segment myocardial infarction (TS-MI)
Original publication
Long-Term Prognostic Impact of OCT-Derived High-Risk Plaque Features: Extended Follow-Up of the CLIMA Study. JACC Cardiovasc Interv. Published 9 June 2025. doi:10.
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