Lots of interesting abstracts and cases were submitted for TCTAP 2024. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!

TCTAP A-034

Clinical Outcomes of Vessels With Discordant Physiology and Imaging-Criteria for Percutaneous Coronary Intervention

By Seokhun Yang, Doyeon Hwang, Jinlong Zhang, Eun-Seok Shin, Chang-Wook Nam, Joon-Hyung Doh, Jian-An Wang, Hitoshi Matsuo, Takashi Kubo, Tsunekazu Kakuta, Bon-Kwon Koo

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Presenter

Seokhun Yang

Authors

Seokhun Yang¹, Doyeon Hwang¹, Jinlong Zhang², Eun-Seok Shin³, Chang-Wook Nam⁴, Joon-Hyung Doh⁵, Jian-An Wang⁶, Hitoshi Matsuo⁷, Takashi Kubo⁸, Tsunekazu Kakuta⁹, Bon-Kwon Koo¹

Affiliation

Seoul National University Hospital, Korea (Republic of)¹, The Second Affiliated Hospital of Zhejiang University School of Medicine, China², Ulsan University Hospital, Korea (Republic of)³, Keimyung University Dongsan Hospital, Korea (Republic of)⁴, Inje University Ilsan Paik Hospital, Korea (Republic of)⁵, The Second Affiliated Hospital Zhejiang University, China⁶, Gifu Heart Center, Japan⁷, Tokyo Medical University, Japan⁸, Tsuchiura Kyodo General Hospital, Japan⁹

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TCTAP A-034

FFR

Clinical Outcomes of Vessels With Discordant Physiology and Imaging-Criteria for Percutaneous Coronary Intervention

Seokhun Yang¹, Doyeon Hwang¹, Jinlong Zhang², Eun-Seok Shin³, Chang-Wook Nam⁴, Joon-Hyung Doh⁵, Jian-An Wang⁶, Hitoshi Matsuo⁷, Takashi Kubo⁸, Tsunekazu Kakuta⁹, Bon-Kwon Koo¹

Background

While recent studies have suggested comparable clinical outcomes between physiology- and imaging-guided decision-making for percutaneous coronary intervention (PCI), the outcomes for vessels with discordant physiology- and imaging-criteria for PCI remain unclear.

Methods

A total of 845 vessels with available coronary CT angiography (CCTA) and invasive fractional flow reserve (FFR) of CCTA-FFRregistry (NCT04037163) from 9 centers in 3 countries were included. All vessels underwent CCTA within 90 days before invasive FFR measurement. Physiology-basedPCI criteria was an FFR ≤0.80, while imaging-based criteria was defined as the presence of high-risk plaque (HRP), both plaque burden ≥ 70%, and a minimum lumen area of < 4.0 mm². The primary endpoint was target vessel failure (TVF, a composite of cardiac death, myocardial infarction, or vascularization) adjudicated by an independent committee.

Results

The mean % diameter stenosis and FFR was 46.1±16.9% and 0.83±0.12, respectively, and 35.0% vessels showed a discordance between FFR ≤0.80 and HRP (15.5% had FFR≤0.80/HRP (-) and 19.5% had FFR >0.80/HRP(+)). In deferred vessels, those with FFR ≤0.80/HRP (-) (HR 4.15 [95% CI 1.56 – 11.0], P =0.004) or FFR>0.80/HRP (+) (HR 3.67 [95% CI 1.61 – 8.32], P =0.002) showed a higher risk of TVF compared to vessels with FFR >0.80/HRP (-) (Figure). In vessels with FFR ≤0.80/HRP (-) or FFR >0.80/HRP (+), revascularized vessels exhibited a lower risk of TVF than deferred vessels (HR 0.28 [95% CI 0.08 – 0.95], P =0.041).

Conclusion

Vessels with discordant physiology- and imaging-based criteria for PCI presented an increased risk of target vessel failure, and PCI for those vessels may reduce the risk for future clinical events.

E-Abstract

TCTAP A-034