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

Detalles Bibliográficos
Autores: 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
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Universidad Autónoma de Madrid
Repositorio:Biblos-e Archivo. Repositorio Institucional de la UAM
Idioma:inglés
OAI Identifier:oai:dnet:biblosearchi::e6d32e9017ddc88c67cb55250fed56dc
Acceso en línea:https://hdl.handle.net/10486/773320
https://dx.doi.org/10.1161/CIRCINTERVENTIONS.124.014667
Access Level:acceso abierto
Palabra clave:acute coronary syndrome
atherosclerosis
fractional flow reserve, myocardial
myocardial infarction
plaque, atherosclerotic
Medicina
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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-obsVolleberg, Rick H.J.A.Rroku, AndiMol, Jan-QuintenS. Hermanides, Renicus S.Leeuwen, Maarten vanBerta, BalázsMeuwissen, MartijnAlfonso Manterola, FernandoWojakowski, WojciechBelkacemi, AnouarRoleder, TomaszKedhi, ElvinRoyen, Niels vanacute coronary syndromeatherosclerosisfractional flow reserve, myocardialmyocardial infarctionplaque, atheroscleroticMedicinaURL: https://clinicaltrials.gov; Unique identifier: NCT02989740; Unique identifier: NCT03857971BACKGROUND: 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 lesionsAmerican Heart AssociationDepartamento de MedicinaFacultad de Medicina20252025-01-22research articlehttp://purl.org/coar/resource_type/c_2df8fbb1EVoRhttp://purl.org/coar/version/c_dc82b40f9837b551info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/10486/773320https://dx.doi.org/10.1161/CIRCINTERVENTIONS.124.01466739840429reponame:Biblos-e Archivo. Repositorio Institucional de la UAMinstname:Universidad Autónoma de MadridInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:dnet:biblosearchi::e6d32e9017ddc88c67cb55250fed56dc2026-06-23T12:46:27Z
dc.title.none.fl_str_mv 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 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
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_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_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_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
dc.creator.none.fl_str_mv 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 Volleberg, Rick H.J.A.
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
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
dc.contributor.none.fl_str_mv Departamento de Medicina
Facultad de Medicina
dc.subject.none.fl_str_mv acute coronary syndrome
atherosclerosis
fractional flow reserve, myocardial
myocardial infarction
plaque, atherosclerotic
Medicina
topic acute coronary syndrome
atherosclerosis
fractional flow reserve, myocardial
myocardial infarction
plaque, atherosclerotic
Medicina
description URL: https://clinicaltrials.gov; Unique identifier: NCT02989740; Unique identifier: NCT03857971
publishDate 2025
dc.date.none.fl_str_mv 2025
2025-01-22
dc.type.none.fl_str_mv research article
http://purl.org/coar/resource_type/c_2df8fbb1
EVoR
http://purl.org/coar/version/c_dc82b40f9837b551
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/10486/773320
https://dx.doi.org/10.1161/CIRCINTERVENTIONS.124.014667
39840429
url https://hdl.handle.net/10486/773320
https://dx.doi.org/10.1161/CIRCINTERVENTIONS.124.014667
identifier_str_mv 39840429
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv American Heart Association
publisher.none.fl_str_mv American Heart Association
dc.source.none.fl_str_mv reponame:Biblos-e Archivo. Repositorio Institucional de la UAM
instname:Universidad Autónoma de Madrid
instname_str Universidad Autónoma de Madrid
reponame_str Biblos-e Archivo. Repositorio Institucional de la UAM
collection Biblos-e Archivo. Repositorio Institucional de la UAM
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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