Correlation between OCT-derived intrastent dimensions and fractional flow reserve measurements after coronary stent implantation and impact on clinical outcome
Insufficient stent expansion, vessel wall injury, and tissue prolapse, all frequently unrecognized by coronary angiography, are predictors of future major adverse cardiac event (MACE) after percutaneous coronary intervention (PCI). Optical coherence tomography (OCT) provides accurate visualization o...
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| Veröffentlicht in: | The Journal of invasive cardiology 2015-05, Vol.27 (5), p.222-228 |
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| container_title | The Journal of invasive cardiology |
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| creator | Reith, Sebastian Battermann, Simone Hellmich, Martin Marx, Nikolaus Burgmaier, Mathias |
| description | Insufficient stent expansion, vessel wall injury, and tissue prolapse, all frequently unrecognized by coronary angiography, are predictors of future major adverse cardiac event (MACE) after percutaneous coronary intervention (PCI). Optical coherence tomography (OCT) provides accurate visualization of these features of inadequate stent deployment, whereas reduced fractional flow reserve (FFR) values after PCI indicate functional significance of a residual intrastent stenosis.
To investigate the relationship of OCT-derived intrastent lumen dimensions and FFR-derived hemodynamic relevance immediately after coronary stent implantation and to evaluate the clinical impact of these parameters at follow-up.
In 66 stable patients with a coronary de novo lesion, treated by stent implantation, post-stenting FFR and OCT data were compared and related to MACE at follow-up.
There was a significant correlation between remaining OCT-derived intrastent percent area stenosis (%AS) and post-stent FFR (r² = 0.491; P |
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To investigate the relationship of OCT-derived intrastent lumen dimensions and FFR-derived hemodynamic relevance immediately after coronary stent implantation and to evaluate the clinical impact of these parameters at follow-up.
In 66 stable patients with a coronary de novo lesion, treated by stent implantation, post-stenting FFR and OCT data were compared and related to MACE at follow-up.
There was a significant correlation between remaining OCT-derived intrastent percent area stenosis (%AS) and post-stent FFR (r² = 0.491; P<.001). According to receiver operating characteristic (ROC) analysis, both final FFR and intrastent %AS predicted MACE at 20 months (FFR: area under the curve [AUC] = 0.768; 95% confidence interval [CI], 0.562-0.973; and optimal cut-off = 0.905; %AS: AUC = 0.807; 95%CI, 0.613-1.000; and optimal cut-off = 16.85%) with moderate diagnostic efficiency. Intrastent %AS (16.60 ± 4.75% vs 7.01 ± 3.49%; P<.001) and the 20-month cumulative incidence of MACE (35.9% vs 5.3%; P=.01) were significantly greater in patients with FFR ≤0.905 (n = 26; 39.4%) compared with FFR >0.905 (n = 40; 60.6%).
OCT-derived residual intrastent %AS is associated with decreased FFR following stent implantation and both are predictors for clinical outcome at follow-up.</description><identifier>EISSN: 1557-2501</identifier><identifier>PMID: 25929298</identifier><language>eng</language><publisher>United States</publisher><subject>Aged ; Coronary Angiography ; Coronary Circulation - physiology ; Coronary Stenosis - diagnosis ; Coronary Stenosis - surgery ; Coronary Vessels - pathology ; Coronary Vessels - physiopathology ; Coronary Vessels - surgery ; Female ; Follow-Up Studies ; Fractional Flow Reserve, Myocardial - physiology ; Humans ; Male ; Percutaneous Coronary Intervention - adverse effects ; Postoperative Complications - diagnosis ; Postoperative Complications - etiology ; Postoperative Complications - physiopathology ; Predictive Value of Tests ; Prosthesis Failure ; Retrospective Studies ; Stents - adverse effects ; Tomography, Optical Coherence - methods</subject><ispartof>The Journal of invasive cardiology, 2015-05, Vol.27 (5), p.222-228</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25929298$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Reith, Sebastian</creatorcontrib><creatorcontrib>Battermann, Simone</creatorcontrib><creatorcontrib>Hellmich, Martin</creatorcontrib><creatorcontrib>Marx, Nikolaus</creatorcontrib><creatorcontrib>Burgmaier, Mathias</creatorcontrib><title>Correlation between OCT-derived intrastent dimensions and fractional flow reserve measurements after coronary stent implantation and impact on clinical outcome</title><title>The Journal of invasive cardiology</title><addtitle>J Invasive Cardiol</addtitle><description>Insufficient stent expansion, vessel wall injury, and tissue prolapse, all frequently unrecognized by coronary angiography, are predictors of future major adverse cardiac event (MACE) after percutaneous coronary intervention (PCI). Optical coherence tomography (OCT) provides accurate visualization of these features of inadequate stent deployment, whereas reduced fractional flow reserve (FFR) values after PCI indicate functional significance of a residual intrastent stenosis.
To investigate the relationship of OCT-derived intrastent lumen dimensions and FFR-derived hemodynamic relevance immediately after coronary stent implantation and to evaluate the clinical impact of these parameters at follow-up.
In 66 stable patients with a coronary de novo lesion, treated by stent implantation, post-stenting FFR and OCT data were compared and related to MACE at follow-up.
There was a significant correlation between remaining OCT-derived intrastent percent area stenosis (%AS) and post-stent FFR (r² = 0.491; P<.001). According to receiver operating characteristic (ROC) analysis, both final FFR and intrastent %AS predicted MACE at 20 months (FFR: area under the curve [AUC] = 0.768; 95% confidence interval [CI], 0.562-0.973; and optimal cut-off = 0.905; %AS: AUC = 0.807; 95%CI, 0.613-1.000; and optimal cut-off = 16.85%) with moderate diagnostic efficiency. Intrastent %AS (16.60 ± 4.75% vs 7.01 ± 3.49%; P<.001) and the 20-month cumulative incidence of MACE (35.9% vs 5.3%; P=.01) were significantly greater in patients with FFR ≤0.905 (n = 26; 39.4%) compared with FFR >0.905 (n = 40; 60.6%).
OCT-derived residual intrastent %AS is associated with decreased FFR following stent implantation and both are predictors for clinical outcome at follow-up.</description><subject>Aged</subject><subject>Coronary Angiography</subject><subject>Coronary Circulation - physiology</subject><subject>Coronary Stenosis - diagnosis</subject><subject>Coronary Stenosis - surgery</subject><subject>Coronary Vessels - pathology</subject><subject>Coronary Vessels - physiopathology</subject><subject>Coronary Vessels - surgery</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fractional Flow Reserve, Myocardial - physiology</subject><subject>Humans</subject><subject>Male</subject><subject>Percutaneous Coronary Intervention - adverse effects</subject><subject>Postoperative Complications - diagnosis</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - physiopathology</subject><subject>Predictive Value of Tests</subject><subject>Prosthesis Failure</subject><subject>Retrospective Studies</subject><subject>Stents - adverse effects</subject><subject>Tomography, Optical Coherence - methods</subject><issn>1557-2501</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1kN1qwyAUgMNgrF23Vxhe7iagJibmcoT9QaE33XUwegRH1ExNy55mrzpLW7w4ePjOd35uijVhrC0pw2RV3Mf4jTElVUfuihVlHc2Pr4u_3ocAk0jGOzRCOgI4tOv3pYJgDqCQcSmImMAlpIwFFzMYkXAK6SDkqUxMSE_-iAJECAdAFkRcAmQ2ZVAnCEj6kLnwi84iY-dJuHRuelLlRHah_JOTcUZmpV-S9BYeilstpgiPl7gpvt5e9_1Hud29f_Yv23KmhKSSdJSBxG1DOOad1rUmHbRCkqZtlICqHhVlI2ChocK4krTpJKP12KgGGK9ZtSmez945-J8FYhqsiRKmPCf4JQ5Z1HJOeYUz-nRBl9GCGuZgbN5tuB61-gfVeHb4</recordid><startdate>201505</startdate><enddate>201505</enddate><creator>Reith, Sebastian</creator><creator>Battermann, Simone</creator><creator>Hellmich, Martin</creator><creator>Marx, Nikolaus</creator><creator>Burgmaier, Mathias</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>201505</creationdate><title>Correlation between OCT-derived intrastent dimensions and fractional flow reserve measurements after coronary stent implantation and impact on clinical outcome</title><author>Reith, Sebastian ; Battermann, Simone ; Hellmich, Martin ; Marx, Nikolaus ; Burgmaier, Mathias</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p211t-1925ec07618089ff4f19e7ac1676dae34bd25be0afe3003c269c524b6d6e58453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Coronary Angiography</topic><topic>Coronary Circulation - physiology</topic><topic>Coronary Stenosis - diagnosis</topic><topic>Coronary Stenosis - surgery</topic><topic>Coronary Vessels - pathology</topic><topic>Coronary Vessels - physiopathology</topic><topic>Coronary Vessels - surgery</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Fractional Flow Reserve, Myocardial - physiology</topic><topic>Humans</topic><topic>Male</topic><topic>Percutaneous Coronary Intervention - adverse effects</topic><topic>Postoperative Complications - diagnosis</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - physiopathology</topic><topic>Predictive Value of Tests</topic><topic>Prosthesis Failure</topic><topic>Retrospective Studies</topic><topic>Stents - adverse effects</topic><topic>Tomography, Optical Coherence - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Reith, Sebastian</creatorcontrib><creatorcontrib>Battermann, Simone</creatorcontrib><creatorcontrib>Hellmich, Martin</creatorcontrib><creatorcontrib>Marx, Nikolaus</creatorcontrib><creatorcontrib>Burgmaier, Mathias</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of invasive cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Reith, Sebastian</au><au>Battermann, Simone</au><au>Hellmich, Martin</au><au>Marx, Nikolaus</au><au>Burgmaier, Mathias</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Correlation between OCT-derived intrastent dimensions and fractional flow reserve measurements after coronary stent implantation and impact on clinical outcome</atitle><jtitle>The Journal of invasive cardiology</jtitle><addtitle>J Invasive Cardiol</addtitle><date>2015-05</date><risdate>2015</risdate><volume>27</volume><issue>5</issue><spage>222</spage><epage>228</epage><pages>222-228</pages><eissn>1557-2501</eissn><abstract>Insufficient stent expansion, vessel wall injury, and tissue prolapse, all frequently unrecognized by coronary angiography, are predictors of future major adverse cardiac event (MACE) after percutaneous coronary intervention (PCI). Optical coherence tomography (OCT) provides accurate visualization of these features of inadequate stent deployment, whereas reduced fractional flow reserve (FFR) values after PCI indicate functional significance of a residual intrastent stenosis.
To investigate the relationship of OCT-derived intrastent lumen dimensions and FFR-derived hemodynamic relevance immediately after coronary stent implantation and to evaluate the clinical impact of these parameters at follow-up.
In 66 stable patients with a coronary de novo lesion, treated by stent implantation, post-stenting FFR and OCT data were compared and related to MACE at follow-up.
There was a significant correlation between remaining OCT-derived intrastent percent area stenosis (%AS) and post-stent FFR (r² = 0.491; P<.001). According to receiver operating characteristic (ROC) analysis, both final FFR and intrastent %AS predicted MACE at 20 months (FFR: area under the curve [AUC] = 0.768; 95% confidence interval [CI], 0.562-0.973; and optimal cut-off = 0.905; %AS: AUC = 0.807; 95%CI, 0.613-1.000; and optimal cut-off = 16.85%) with moderate diagnostic efficiency. Intrastent %AS (16.60 ± 4.75% vs 7.01 ± 3.49%; P<.001) and the 20-month cumulative incidence of MACE (35.9% vs 5.3%; P=.01) were significantly greater in patients with FFR ≤0.905 (n = 26; 39.4%) compared with FFR >0.905 (n = 40; 60.6%).
OCT-derived residual intrastent %AS is associated with decreased FFR following stent implantation and both are predictors for clinical outcome at follow-up.</abstract><cop>United States</cop><pmid>25929298</pmid><tpages>7</tpages></addata></record> |
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| subjects | Aged Coronary Angiography Coronary Circulation - physiology Coronary Stenosis - diagnosis Coronary Stenosis - surgery Coronary Vessels - pathology Coronary Vessels - physiopathology Coronary Vessels - surgery Female Follow-Up Studies Fractional Flow Reserve, Myocardial - physiology Humans Male Percutaneous Coronary Intervention - adverse effects Postoperative Complications - diagnosis Postoperative Complications - etiology Postoperative Complications - physiopathology Predictive Value of Tests Prosthesis Failure Retrospective Studies Stents - adverse effects Tomography, Optical Coherence - methods |
| title | Correlation between OCT-derived intrastent dimensions and fractional flow reserve measurements after coronary stent implantation and impact on clinical outcome |
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