Optimal intravascular ultrasound criteria for defining the functional significance of intermediate coronary stenosis: an international multicenter study.

MedStar author(s):
Citation: Cardiology. 127(4):256-62, 2014.PMID: 24480866Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | Multicenter Study | Research Support, Non-U.S. Gov'tSubject headings: *Coronary Stenosis/us [Ultrasonography] | *Registries | *Ultrasonography, Interventional/st [Standards] | Aged | Asian Continental Ancestry Group | Coronary Stenosis/co [Complications] | Coronary Vessels/us [Ultrasonography] | European Continental Ancestry Group | Female | Fractional Flow Reserve, Myocardial | Humans | Male | Middle Aged | Myocardial Ischemia/et [Etiology]Year: 2014Local holdings: Available online through MWHC library: 2007 - present (after 1 year), Available in print through MWHC library: 1999 - 2006ISSN:
  • 0008-6312
Name of journal: CardiologyAbstract: CONCLUSION: In this pooled analysis, an IVUS MLA of 2.75 mm(2) was the BCV to define the functional significance of intermediate coronary stenosis. However, when IVUS MLA is used to determine the functional significance, both the lesion and patient characteristics should be considered.METHODS: Eleven centers worldwide were invited to provide their clinical, IVUS and fractional flow reserve (FFR) data. A total of 881 lesions were enrolled.OBJECTIVE: We aimed to assess the ideal cut-off value of minimal lumen area (MLA) by intravascular ultrasound (IVUS) and its diagnostic performance to predict ischemia, using a large-scale, pooled analysis.RESULTS: Angiographic % diameter stenosis (r = -0.373, p < 0.0001) and IVUS MLA (r = 0.289, p < 0.0001) correlated with FFR. Best cut-off value (BCV) of IVUS MLA to define the functional significance (FFR <0.8) was 2.75 mm(2) (AUC 0.646, 95% CI 0.609-0.684). When the diagnostic performance of IVUS MLA was tested according to the lesion location, BCV could be found only in lesions in the proximal artery and the mid-left anterior descending artery. Interestingly, Asians (n = 623) and Westerners (n = 258) showed different demographic and lesion characteristics as well as different BCVs to define ischemia. The BCV for the proximal/mid-left anterior descending artery lesions was 2.75 mm(2) (AUC 0.688, 95% CI 0.635-0.742) in Asians and 3.0 mm(2) (AUC 0.695, 95% CI 0.605-0.786) in Westerners.All authors: Akasaka T, Ben-Dor I, Costa MA, Doh JH, Escaned J, Gonzalo N, Han JK, Hu X, Kim HS, Koo BK, Kubo T, Lee CH, Ma S, Murata N, Nam CW, Park KW, Park SK, Pichard A, Tahk SJ, Tanaka N, Waksman R, Wang J, Yang HM, Yoon MHFiscal year: FY2015Digital Object Identifier: Date added to catalog: 2015-03-17
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 24480866 Available 24480866

Available online through MWHC library: 2007 - present (after 1 year), Available in print through MWHC library: 1999 - 2006

CONCLUSION: In this pooled analysis, an IVUS MLA of 2.75 mm(2) was the BCV to define the functional significance of intermediate coronary stenosis. However, when IVUS MLA is used to determine the functional significance, both the lesion and patient characteristics should be considered.

METHODS: Eleven centers worldwide were invited to provide their clinical, IVUS and fractional flow reserve (FFR) data. A total of 881 lesions were enrolled.

OBJECTIVE: We aimed to assess the ideal cut-off value of minimal lumen area (MLA) by intravascular ultrasound (IVUS) and its diagnostic performance to predict ischemia, using a large-scale, pooled analysis.

RESULTS: Angiographic % diameter stenosis (r = -0.373, p < 0.0001) and IVUS MLA (r = 0.289, p < 0.0001) correlated with FFR. Best cut-off value (BCV) of IVUS MLA to define the functional significance (FFR <0.8) was 2.75 mm(2) (AUC 0.646, 95% CI 0.609-0.684). When the diagnostic performance of IVUS MLA was tested according to the lesion location, BCV could be found only in lesions in the proximal artery and the mid-left anterior descending artery. Interestingly, Asians (n = 623) and Westerners (n = 258) showed different demographic and lesion characteristics as well as different BCVs to define ischemia. The BCV for the proximal/mid-left anterior descending artery lesions was 2.75 mm(2) (AUC 0.688, 95% CI 0.635-0.742) in Asians and 3.0 mm(2) (AUC 0.695, 95% CI 0.605-0.786) in Westerners.

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