Preprocedural physiological assessment of coronary disease patterns to predict haemodynamic outcomes post-PCI
Even with intracoronary imaging-guided stent optimisation, suboptimal haemodynamic outcomes post-percutaneous coronary intervention (PCI) can be related to residual lesions in non-stented segments. Preprocedural assessment of pathophysiological coronary artery disease (CAD) patterns could help predi...
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| Veröffentlicht in: | EuroIntervention 2023-12, Vol.19 (11), p.e891-e902 |
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| creator | Kotoku, Nozomi Ninomiya, Kai Masuda, Shinichiro O'Leary, Neil Garg, Scot Naito, Mareka Miyashita, Kotaro Tobe, Akihiro Kageyama, Shigetaka Tsai, Tsung Ying Revaiah, Pruthvi C Tu, Shengxian Kozuma, Ken Kawashima, Hideyuki Ishibashi, Yuki Nakazawa, Gaku Takahashi, Kuniaki Okamura, Takayuki Miyazaki, Yosuke Tateishi, Hiroki Nakamura, Masato Kogame, Norihiro Asano, Taku Nakatani, Shimpei Morino, Yoshihiro Ishida, Masaru Katagiri, Yuki Ono, Masafumi Hara, Hironori Sotomi, Yohei Tanabe, Kengo Ozaki, Yukio Muramatsu, Takashi Dijkstra, Jouke Onuma, Yoshinobu Serruys, Patrick W |
| description | Even with intracoronary imaging-guided stent optimisation, suboptimal haemodynamic outcomes post-percutaneous coronary intervention (PCI) can be related to residual lesions in non-stented segments. Preprocedural assessment of pathophysiological coronary artery disease (CAD) patterns could help predict the physiological response to PCI.
The aim of this study was to assess the relationship between preprocedural pathophysiological haemodynamic patterns and intracoronary imaging findings, as well as their association with physiological outcomes immediately post-PCI.
Data from 206 patients with chronic coronary syndrome enrolled in the ASET-JAPAN study were analysed. Pathophysiological CAD patterns were characterised using Murray law-based quantitative flow ratio (μQFR)-derived indices acquired from pre-PCI angiograms. The diffuseness of CAD was defined by the pullback pressure gradient (PPG) index. Intracoronary imaging in stented segments after stent optimisation was also analysed.
In the multivariable analysis, diffuse disease - defined by the pre-PCI μQFR-PPG index - was an independent factor for predicting a post-PCI μQFR |
| doi_str_mv | 10.4244/eij-d-23-00516 |
| format | Article |
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The aim of this study was to assess the relationship between preprocedural pathophysiological haemodynamic patterns and intracoronary imaging findings, as well as their association with physiological outcomes immediately post-PCI.
Data from 206 patients with chronic coronary syndrome enrolled in the ASET-JAPAN study were analysed. Pathophysiological CAD patterns were characterised using Murray law-based quantitative flow ratio (μQFR)-derived indices acquired from pre-PCI angiograms. The diffuseness of CAD was defined by the pullback pressure gradient (PPG) index. Intracoronary imaging in stented segments after stent optimisation was also analysed.
In the multivariable analysis, diffuse disease - defined by the pre-PCI μQFR-PPG index - was an independent factor for predicting a post-PCI μQFR <0.91 (per 0.1 decrease of PPG index, odds ratio 1.57, 95% confidence interval: 1.07-2.34; p=0.022), whereas the stent expansion index (EI) was not associated with a suboptimal post-PCI μQFR. Among vessels with an EI ≥80% and post-PCI μQFR <0.91, 84.0% of those vessels had a diffuse pattern preprocedure. There was no significant difference in EI between vessels with diffuse disease and those with focal disease. The average plaque burden in the stented segment was significantly larger in vessels with a preprocedural diffuse CAD pattern.
A physiological diffuse pattern preprocedure was an independent factor in predicting unfavourable immediate haemodynamic outcomes post-PCI, even after stent optimisation using intracoronary imaging. Preprocedural assessment of CAD patterns could identify patients who are likely to exhibit superior immediate haemodynamic outcomes following PCI.</description><identifier>ISSN: 1969-6213</identifier><identifier>ISSN: 1774-024X</identifier><identifier>EISSN: 1969-6213</identifier><identifier>DOI: 10.4244/eij-d-23-00516</identifier><identifier>PMID: 37960875</identifier><language>eng</language><publisher>France: Europa Edition</publisher><subject>Clinical Research ; Coronary Angiography - methods ; Coronary Artery Disease - diagnostic imaging ; Coronary Artery Disease - surgery ; Coronary Vessels - diagnostic imaging ; Coronary Vessels - pathology ; Coronary Vessels - surgery ; Drug-Eluting Stent ; Fractional Flow Reserve ; Fractional Flow Reserve, Myocardial ; Hemodynamics ; Humans ; Intravascular Ultrasound ; Optical Coherence Tomography ; Percutaneous Coronary Intervention ; Predictive Value of Tests ; Stable Angina ; Treatment Outcome</subject><ispartof>EuroIntervention, 2023-12, Vol.19 (11), p.e891-e902</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c417t-e5d65fce788eb3c7e3da400afaba457d0c6a8788c61756a74ad7159ac3a4eb3f3</citedby><cites>FETCH-LOGICAL-c417t-e5d65fce788eb3c7e3da400afaba457d0c6a8788c61756a74ad7159ac3a4eb3f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10719743/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10719743/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37960875$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kotoku, Nozomi</creatorcontrib><creatorcontrib>Ninomiya, Kai</creatorcontrib><creatorcontrib>Masuda, Shinichiro</creatorcontrib><creatorcontrib>O'Leary, Neil</creatorcontrib><creatorcontrib>Garg, Scot</creatorcontrib><creatorcontrib>Naito, Mareka</creatorcontrib><creatorcontrib>Miyashita, Kotaro</creatorcontrib><creatorcontrib>Tobe, Akihiro</creatorcontrib><creatorcontrib>Kageyama, Shigetaka</creatorcontrib><creatorcontrib>Tsai, Tsung Ying</creatorcontrib><creatorcontrib>Revaiah, Pruthvi C</creatorcontrib><creatorcontrib>Tu, Shengxian</creatorcontrib><creatorcontrib>Kozuma, Ken</creatorcontrib><creatorcontrib>Kawashima, Hideyuki</creatorcontrib><creatorcontrib>Ishibashi, Yuki</creatorcontrib><creatorcontrib>Nakazawa, Gaku</creatorcontrib><creatorcontrib>Takahashi, Kuniaki</creatorcontrib><creatorcontrib>Okamura, Takayuki</creatorcontrib><creatorcontrib>Miyazaki, Yosuke</creatorcontrib><creatorcontrib>Tateishi, Hiroki</creatorcontrib><creatorcontrib>Nakamura, Masato</creatorcontrib><creatorcontrib>Kogame, Norihiro</creatorcontrib><creatorcontrib>Asano, Taku</creatorcontrib><creatorcontrib>Nakatani, Shimpei</creatorcontrib><creatorcontrib>Morino, Yoshihiro</creatorcontrib><creatorcontrib>Ishida, Masaru</creatorcontrib><creatorcontrib>Katagiri, Yuki</creatorcontrib><creatorcontrib>Ono, Masafumi</creatorcontrib><creatorcontrib>Hara, Hironori</creatorcontrib><creatorcontrib>Sotomi, Yohei</creatorcontrib><creatorcontrib>Tanabe, Kengo</creatorcontrib><creatorcontrib>Ozaki, Yukio</creatorcontrib><creatorcontrib>Muramatsu, Takashi</creatorcontrib><creatorcontrib>Dijkstra, Jouke</creatorcontrib><creatorcontrib>Onuma, Yoshinobu</creatorcontrib><creatorcontrib>Serruys, Patrick W</creatorcontrib><title>Preprocedural physiological assessment of coronary disease patterns to predict haemodynamic outcomes post-PCI</title><title>EuroIntervention</title><addtitle>EuroIntervention</addtitle><description>Even with intracoronary imaging-guided stent optimisation, suboptimal haemodynamic outcomes post-percutaneous coronary intervention (PCI) can be related to residual lesions in non-stented segments. Preprocedural assessment of pathophysiological coronary artery disease (CAD) patterns could help predict the physiological response to PCI.
The aim of this study was to assess the relationship between preprocedural pathophysiological haemodynamic patterns and intracoronary imaging findings, as well as their association with physiological outcomes immediately post-PCI.
Data from 206 patients with chronic coronary syndrome enrolled in the ASET-JAPAN study were analysed. Pathophysiological CAD patterns were characterised using Murray law-based quantitative flow ratio (μQFR)-derived indices acquired from pre-PCI angiograms. The diffuseness of CAD was defined by the pullback pressure gradient (PPG) index. Intracoronary imaging in stented segments after stent optimisation was also analysed.
In the multivariable analysis, diffuse disease - defined by the pre-PCI μQFR-PPG index - was an independent factor for predicting a post-PCI μQFR <0.91 (per 0.1 decrease of PPG index, odds ratio 1.57, 95% confidence interval: 1.07-2.34; p=0.022), whereas the stent expansion index (EI) was not associated with a suboptimal post-PCI μQFR. Among vessels with an EI ≥80% and post-PCI μQFR <0.91, 84.0% of those vessels had a diffuse pattern preprocedure. There was no significant difference in EI between vessels with diffuse disease and those with focal disease. The average plaque burden in the stented segment was significantly larger in vessels with a preprocedural diffuse CAD pattern.
A physiological diffuse pattern preprocedure was an independent factor in predicting unfavourable immediate haemodynamic outcomes post-PCI, even after stent optimisation using intracoronary imaging. Preprocedural assessment of CAD patterns could identify patients who are likely to exhibit superior immediate haemodynamic outcomes following PCI.</description><subject>Clinical Research</subject><subject>Coronary Angiography - methods</subject><subject>Coronary Artery Disease - diagnostic imaging</subject><subject>Coronary Artery Disease - surgery</subject><subject>Coronary Vessels - diagnostic imaging</subject><subject>Coronary Vessels - pathology</subject><subject>Coronary Vessels - surgery</subject><subject>Drug-Eluting Stent</subject><subject>Fractional Flow Reserve</subject><subject>Fractional Flow Reserve, Myocardial</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Intravascular Ultrasound</subject><subject>Optical Coherence Tomography</subject><subject>Percutaneous Coronary Intervention</subject><subject>Predictive Value of Tests</subject><subject>Stable Angina</subject><subject>Treatment Outcome</subject><issn>1969-6213</issn><issn>1774-024X</issn><issn>1969-6213</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVUEFOwzAQtBCIQuHKEfkDKXbsxMkJoVKgqBI9wNna2pvWVRNHdorU3xMoVOW0u5qdGc0QcsPZSKZS3qFbJzZJRcJYxvMTcsHLvEzylIvTo31ALmNcMyYLxtU5GQhV5qxQ2QWp5wHb4A3abYANbVe76PzGL53pL4gRY6yx6aivqPHBNxB21LqIEJG20HUYmkg7T9uA1pmOrgBrb3cN1M5Qv-2MrzHS1scumY-nV-Ssgk3E6985JB9Pk_fxSzJ7e56OH2aJkVx1CWY2zyqDqihwIYxCYUEyBhUsQGbKMpND0YMm5yrLQUmwimclGAGyJ1RiSO73uu12UaM1fYI-nW6Dq_sA2oPT_5HGrfTSf2rOFC-VFL3CaK9ggo8xYHUgc6a_m9eT6at-1KnQP833hNtjy8P7X9XiCxpbhJU</recordid><startdate>20231201</startdate><enddate>20231201</enddate><creator>Kotoku, Nozomi</creator><creator>Ninomiya, Kai</creator><creator>Masuda, Shinichiro</creator><creator>O'Leary, Neil</creator><creator>Garg, Scot</creator><creator>Naito, Mareka</creator><creator>Miyashita, Kotaro</creator><creator>Tobe, Akihiro</creator><creator>Kageyama, Shigetaka</creator><creator>Tsai, Tsung Ying</creator><creator>Revaiah, Pruthvi C</creator><creator>Tu, Shengxian</creator><creator>Kozuma, Ken</creator><creator>Kawashima, Hideyuki</creator><creator>Ishibashi, Yuki</creator><creator>Nakazawa, Gaku</creator><creator>Takahashi, Kuniaki</creator><creator>Okamura, Takayuki</creator><creator>Miyazaki, Yosuke</creator><creator>Tateishi, Hiroki</creator><creator>Nakamura, Masato</creator><creator>Kogame, Norihiro</creator><creator>Asano, Taku</creator><creator>Nakatani, Shimpei</creator><creator>Morino, Yoshihiro</creator><creator>Ishida, Masaru</creator><creator>Katagiri, Yuki</creator><creator>Ono, Masafumi</creator><creator>Hara, Hironori</creator><creator>Sotomi, Yohei</creator><creator>Tanabe, Kengo</creator><creator>Ozaki, Yukio</creator><creator>Muramatsu, Takashi</creator><creator>Dijkstra, Jouke</creator><creator>Onuma, Yoshinobu</creator><creator>Serruys, Patrick W</creator><general>Europa Edition</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>20231201</creationdate><title>Preprocedural physiological assessment of coronary disease patterns to predict haemodynamic outcomes post-PCI</title><author>Kotoku, Nozomi ; Ninomiya, Kai ; Masuda, Shinichiro ; O'Leary, Neil ; Garg, Scot ; Naito, Mareka ; Miyashita, Kotaro ; Tobe, Akihiro ; Kageyama, Shigetaka ; Tsai, Tsung Ying ; Revaiah, Pruthvi C ; Tu, Shengxian ; Kozuma, Ken ; Kawashima, Hideyuki ; Ishibashi, Yuki ; Nakazawa, Gaku ; Takahashi, Kuniaki ; Okamura, Takayuki ; Miyazaki, Yosuke ; Tateishi, Hiroki ; Nakamura, Masato ; Kogame, Norihiro ; Asano, Taku ; Nakatani, Shimpei ; Morino, Yoshihiro ; Ishida, Masaru ; Katagiri, Yuki ; Ono, Masafumi ; Hara, Hironori ; Sotomi, Yohei ; Tanabe, Kengo ; Ozaki, Yukio ; Muramatsu, Takashi ; Dijkstra, Jouke ; Onuma, Yoshinobu ; Serruys, Patrick W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c417t-e5d65fce788eb3c7e3da400afaba457d0c6a8788c61756a74ad7159ac3a4eb3f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Clinical Research</topic><topic>Coronary Angiography - 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Preprocedural assessment of pathophysiological coronary artery disease (CAD) patterns could help predict the physiological response to PCI.
The aim of this study was to assess the relationship between preprocedural pathophysiological haemodynamic patterns and intracoronary imaging findings, as well as their association with physiological outcomes immediately post-PCI.
Data from 206 patients with chronic coronary syndrome enrolled in the ASET-JAPAN study were analysed. Pathophysiological CAD patterns were characterised using Murray law-based quantitative flow ratio (μQFR)-derived indices acquired from pre-PCI angiograms. The diffuseness of CAD was defined by the pullback pressure gradient (PPG) index. Intracoronary imaging in stented segments after stent optimisation was also analysed.
In the multivariable analysis, diffuse disease - defined by the pre-PCI μQFR-PPG index - was an independent factor for predicting a post-PCI μQFR <0.91 (per 0.1 decrease of PPG index, odds ratio 1.57, 95% confidence interval: 1.07-2.34; p=0.022), whereas the stent expansion index (EI) was not associated with a suboptimal post-PCI μQFR. Among vessels with an EI ≥80% and post-PCI μQFR <0.91, 84.0% of those vessels had a diffuse pattern preprocedure. There was no significant difference in EI between vessels with diffuse disease and those with focal disease. The average plaque burden in the stented segment was significantly larger in vessels with a preprocedural diffuse CAD pattern.
A physiological diffuse pattern preprocedure was an independent factor in predicting unfavourable immediate haemodynamic outcomes post-PCI, even after stent optimisation using intracoronary imaging. Preprocedural assessment of CAD patterns could identify patients who are likely to exhibit superior immediate haemodynamic outcomes following PCI.</abstract><cop>France</cop><pub>Europa Edition</pub><pmid>37960875</pmid><doi>10.4244/eij-d-23-00516</doi></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1969-6213 |
| ispartof | EuroIntervention, 2023-12, Vol.19 (11), p.e891-e902 |
| issn | 1969-6213 1774-024X 1969-6213 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10719743 |
| source | MEDLINE; PubMed Central |
| subjects | Clinical Research Coronary Angiography - methods Coronary Artery Disease - diagnostic imaging Coronary Artery Disease - surgery Coronary Vessels - diagnostic imaging Coronary Vessels - pathology Coronary Vessels - surgery Drug-Eluting Stent Fractional Flow Reserve Fractional Flow Reserve, Myocardial Hemodynamics Humans Intravascular Ultrasound Optical Coherence Tomography Percutaneous Coronary Intervention Predictive Value of Tests Stable Angina Treatment Outcome |
| title | Preprocedural physiological assessment of coronary disease patterns to predict haemodynamic outcomes post-PCI |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T19%3A18%3A47IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-pubmed_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Preprocedural%20physiological%20assessment%20of%20coronary%20disease%20patterns%20to%20predict%20haemodynamic%20outcomes%20post-PCI&rft.jtitle=EuroIntervention&rft.au=Kotoku,%20Nozomi&rft.date=2023-12-01&rft.volume=19&rft.issue=11&rft.spage=e891&rft.epage=e902&rft.pages=e891-e902&rft.issn=1969-6213&rft.eissn=1969-6213&rft_id=info:doi/10.4244/eij-d-23-00516&rft_dat=%3Cpubmed_cross%3E37960875%3C/pubmed_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/37960875&rfr_iscdi=true |