Coronary disease & ACSCohort study
Prognostic Time Frame of Plaque and Hemodynamic Characteristics and Integrative Risk Prediction for Acute Coronary Syndrome
- Retrospective cohort study
- core laboratory analysis
Authors' conclusion
Increased luminal stenosis, plaque burden, and ΔFFRCT were associated with shorter test-to-ACS event time. The prognostic impact of lumen, plaque, and local hemodynamic characteristics was most relevant to ACS risk within a 2-year period, with higher risk observed when specific combinations of them were present.
Study context
- Population
- Patients who underwent coronary computed tomography angiography (CTA) and experienced acute coronary syndrome (ACS) between 1 month and 3 years of follow-up351 patients
- Participants
- 363 vs 2,088
- Exposure
- Culprit vs nonculprit lesions by test-to-event time group
- Culpritn = 363
- Nonculpritn = 2,088reference
- Outcome
- Association of lesion characteristics (stenosis, plaque burden, APC, ΔFFRCT) with test-to-event time and prognostic impact on ACS
- Follow-up
- 1 month to 3 years
Main finding
As reported in the abstract
Among culprit lesions, shorter test-to-event time associated with higher luminal stenosis, plaque burden and ΔFFRCT
P for trend < 0.001 for all
AUC of combined 4 characteristics for ACS culprit lesions, significantly reduced beyond 2 years
0.851 vs 0.741; P = 0.006
Observational data: associations, not effects.
Further findings
Proportion of lesions becoming ACS culprit within <2 years, by lesion characteristics (vs average 12.1%)
- 4 characteristics
- 49.3%; P < 0.001
- Obstructive, plaque burden ≥70% and ΔFFRCT ≥0.10
- 33.0%; P < 0.001
- Obstructive, plaque burden ≥70% and adverse plaque characteristics (APC) ≥2
- 31.2%; P < 0.001
- Plaque burden ≥70% and ΔFFRCT ≥0.10
- 21.5%; P = 0.016
Patient characteristics and proportion of ACS culprit lesions across short, mid and long groups
- Patient characteristics, including CV risk factors, did not differ
- P > 0.05 for all
- Proportion of ACS culprit lesions similar
- P = 0.552
Original publication
Summarised from the published abstract; every number is checked against it