FFR-Negative Nonculprit High-Risk Plaques and Clinical Outcomes in High-Risk Populations: An Individual Patient-Data Pooled Analysis From COMBINE (OCT-FFR) and PECTUS-obs
URL: https://clinicaltrials.gov; Unique identifier: NCT02989740; Unique identifier: NCT03857971
| Authors: | ; ; ; ; ; ; ; ; ; ; ; ; |
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| Format: | Article |
| Publication date: | 2025 |
| Country: | España |
| Institution: | Universidad Autónoma de Madrid |
| Repository: | Biblos-e Archivo. Repositorio Institucional de la UAM |
| Language: | English |
| OAI Identifier: | oai:dnet:biblosearchi::e6d32e9017ddc88c67cb55250fed56dc |
| Online Access: | https://hdl.handle.net/10486/773320 https://dx.doi.org/10.1161/CIRCINTERVENTIONS.124.014667 |
| Access Level: | Open access |
| Keyword: | acute coronary syndrome atherosclerosis fractional flow reserve, myocardial myocardial infarction plaque, atherosclerotic Medicina |
| _version_ | 1878739164791308288 |
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| author | Volleberg, Rick H.J.A. |
| author2 | Rroku, Andi Mol, Jan-Quinten S. Hermanides, Renicus S. Leeuwen, Maarten van Berta, Balázs Meuwissen, Martijn Alfonso Manterola, Fernando Wojakowski, Wojciech Belkacemi, Anouar Roleder, Tomasz Kedhi, Elvin Royen, Niels van |
| author2_role | author author author author author author author author author author author author |
| author_browse | Alfonso Manterola, Fernando Belkacemi, Anouar Berta, Balázs Kedhi, Elvin Leeuwen, Maarten van Meuwissen, Martijn Mol, Jan-Quinten Roleder, Tomasz Royen, Niels van Rroku, Andi S. Hermanides, Renicus S. Volleberg, Rick H.J.A. Wojakowski, Wojciech |
| author_facet | Volleberg, Rick H.J.A. Rroku, Andi Mol, Jan-Quinten S. Hermanides, Renicus S. Leeuwen, Maarten van Berta, Balázs Meuwissen, Martijn Alfonso Manterola, Fernando Wojakowski, Wojciech Belkacemi, Anouar Roleder, Tomasz Kedhi, Elvin Royen, Niels van |
| author_role | author |
| collection | Biblos-e Archivo. Repositorio Institucional de la UAM |
| description | URL: https://clinicaltrials.gov; Unique identifier: NCT02989740; Unique identifier: NCT03857971 |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_bc4da2ee74c64b3ebf4873e59db4cb72 |
| identifier_str_mv | 39840429 |
| institution | Universidad Autónoma de Madrid |
| instname_str | Universidad Autónoma de Madrid |
| language | eng |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:dnet:biblosearchi::e6d32e9017ddc88c67cb55250fed56dc |
| publishDate | 2025 |
| publishDateSort | 2025 |
| publisher | American Heart Association |
| publisherStr | American Heart Association |
| reponame_str | Biblos-e Archivo. Repositorio Institucional de la UAM |
| spelling | FFR-Negative Nonculprit High-Risk Plaques and Clinical Outcomes in High-Risk Populations: An Individual Patient-Data Pooled Analysis From COMBINE (OCT-FFR) and PECTUS-obs Volleberg, Rick H.J.A. Rroku, Andi Mol, Jan-Quinten S. Hermanides, Renicus S. Leeuwen, Maarten van Berta, Balázs Meuwissen, Martijn Alfonso Manterola, Fernando Wojakowski, Wojciech Belkacemi, Anouar Roleder, Tomasz Kedhi, Elvin Royen, Niels van acute coronary syndrome atherosclerosis fractional flow reserve, myocardial myocardial infarction plaque, atherosclerotic Medicina URL: https://clinicaltrials.gov; Unique identifier: NCT02989740; Unique identifier: NCT03857971 BACKGROUND: Despite fractional flow reserve (FFR)–guided deferral of revascularization, recurrent events in patients with diabetes or after myocardial infarction remain common. This study aimed to assess the association between FFR-negative but high-risk nonculprit lesions and clinical outcomes. METHODS: This is a patient-level pooled analysis of the prospective natural-history COMBINE (OCT-FFR) study (Optical Coherence Tomography Morphologic and Fractional Flow Reserve Assessment in Diabetes Mellitus Patients) and PECTUS-obs study (Identification of Risk Factors for Acute Coronary Events by OCT After STEMI and NSTEMI Patients With Residual Non- Flow Limiting Lesions). Optical coherence tomography was performed on all FFR-negative (FFR >0.80) native nonculprit lesions. Patients or lesions with a high-risk plaque were compared with those without a high-risk plaque. A high-risk plaque was defined in the presence of at least 2 prespecified criteria: (1) lipid arc ≥90o, (2) minimum fibrous cap thickness <65 µm, and (3) presence of either plaque rupture or thrombus. The primary end points were native major adverse cardiovascular events (composite of all-cause mortality, nonfatal myocardial infarction, or unplanned revascularization excluding stent-failure–related events and nonattributable events) and target lesion failure (composite of cardiac death, target vessel myocardial infarction, or target lesion revascularization). RESULTS: Among 810 patients, 450 (55.6%) had a history of diabetes and 482 (59.5%) presented with myocardial infarction. At least 1 high-risk plaque was identified in 271 (33.5%) patients and 287 (30.6%) lesions. Over a median follow-up of 761 (interquartile range, 731–1175) days, the presence of a high-risk plaque was associated with patient-level native major adverse cardiovascular events (hazard ratio, 2.127 [95% CI, 1.451–3.120]; P<0.001) and lesion-level target lesion failure (hazard ratio, 2.623 [95% CI, 1.559–4.414]; P<0.001). The risk of adverse outcomes increased with the copresence of multiple high-risk features. CONCLUSIONS: FFR-negative but high-risk nonculprit lesions are associated with adverse patient- and lesion-level clinical outcomes. These findings emphasize the additional value of intracoronary imaging in patients with FFR-negative nonculprit lesions American Heart Association https://hdl.handle.net/10486/773320 https://dx.doi.org/10.1161/CIRCINTERVENTIONS.124.014667 39840429 |
| spellingShingle | FFR-Negative Nonculprit High-Risk Plaques and Clinical Outcomes in High-Risk Populations: An Individual Patient-Data Pooled Analysis From COMBINE (OCT-FFR) and PECTUS-obs Volleberg, Rick H.J.A. acute coronary syndrome atherosclerosis fractional flow reserve, myocardial myocardial infarction plaque, atherosclerotic Medicina |
| title | FFR-Negative Nonculprit High-Risk Plaques and Clinical Outcomes in High-Risk Populations: An Individual Patient-Data Pooled Analysis From COMBINE (OCT-FFR) and PECTUS-obs |
| title_full | FFR-Negative Nonculprit High-Risk Plaques and Clinical Outcomes in High-Risk Populations: An Individual Patient-Data Pooled Analysis From COMBINE (OCT-FFR) and PECTUS-obs |
| title_fullStr | FFR-Negative Nonculprit High-Risk Plaques and Clinical Outcomes in High-Risk Populations: An Individual Patient-Data Pooled Analysis From COMBINE (OCT-FFR) and PECTUS-obs |
| title_full_unstemmed | FFR-Negative Nonculprit High-Risk Plaques and Clinical Outcomes in High-Risk Populations: An Individual Patient-Data Pooled Analysis From COMBINE (OCT-FFR) and PECTUS-obs |
| title_short | FFR-Negative Nonculprit High-Risk Plaques and Clinical Outcomes in High-Risk Populations: An Individual Patient-Data Pooled Analysis From COMBINE (OCT-FFR) and PECTUS-obs |
| title_sort | FFR-Negative Nonculprit High-Risk Plaques and Clinical Outcomes in High-Risk Populations: An Individual Patient-Data Pooled Analysis From COMBINE (OCT-FFR) and PECTUS-obs |
| topic | acute coronary syndrome atherosclerosis fractional flow reserve, myocardial myocardial infarction plaque, atherosclerotic Medicina |
| topic_facet | acute coronary syndrome atherosclerosis fractional flow reserve, myocardial myocardial infarction plaque, atherosclerotic Medicina |
| url | https://hdl.handle.net/10486/773320 https://dx.doi.org/10.1161/CIRCINTERVENTIONS.124.014667 |