Radial wall strain for residual risk stratification after percutaneous coronary intervention
Authors' conclusion
In this retrospective post hoc analysis, RWS was independently associated with long-term adverse events in deferred non-target vessels, with its prognostic value most evident for subsequent non-target vessel revascularisation. Elevated baseline RWSmax was strongly associated with the NT-VOCE, with the highest predictive accuracy in vessels with high-quality angiographic imaging. Ongoing and planned prospective, randomised trials are evaluating the role of RWS-guided risk stratification.
Study context
- Population
- Patients after percutaneous coronary intervention in the TARGET All Comers randomised trial, with untreated non-target vesselspatients with radial wall strain (RWS) successfully evaluated in 1,384 non-target vessels, 1,551 enrolled patients included
- Participants
- 802 patients
- Predictors
- Baseline maximal radial wall strain (RWSmax) from routine angiography by an artificial intelligence algorithm; prespecified cutoff RWSmax ≥13%
- Predicted outcome
- non-target vessel-oriented composite endpoint (NT-VOCE), a composite of cardiac death, non-target vessel myocardial infarction and non-target vessel revascularisation
Methodological detailsblinded analysis, retrospective, TARGET All Comers randomised trial
- Blinded analysis
- Retrospective
- TARGET All Comers randomised trial
Model performance
As reported in the abstract
Further findings
Non-target vessel-oriented composite endpoint (NT-VOCE), adjusted HR for baseline RWSmax
- Adjusted HR (95% CI 3.14-7.40; p<0.0001)
- 4.82
- Baseline RWSmax independently predicted the NT-VOCE
Non-target vessel revascularisation
- Adjusted AUC (95% CI 0.88-0.95; p<0.0001)
- 0.92
- Predictive accuracy was highest for non-target vessel revascularisation
NT-VOCE, subgroup with high-quality angiographic images
- Adjusted HR (95% CI 3.15-15.07; p<0.0001)
- 6.89
Original publication
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