Vulnerable plaque presents prognostic implications in addition to functional significance. The aim of this study was to identify relevant features of vulnerable plaque in functionally significant lesions. In this multicenter, prospective study conducted across 5 countries, including patients who had invasive fractional flow reserve (FFR) ≤0.80, a total of 95 patients with available pullback pressure gradient (PPG) and plaque analysis on coronary computed tomographic angiography and optical coherence tomography were analyzed. Vulnerable plaque was defined as the presence of plaque rupture or thin-cap fibroatheroma on optical coherence tomography. Among the 25 clinical characteristics, invasive angiographic findings, physiological indexes, and coronary computed tomographic angiographic findings, significant predictors of vulnerable plaque were identified. Mean percentage diameter stenosis, FFR, and PPG were 77.8% ± 14.6%, 0.66 ± 0.13, and 0.65 ± 0.13, respectively. Vulnerable plaque was present in 53 lesions (55.8%). PPG and FFR were identified as significant predictors of vulnerable plaque ( 0.05 for all). PPG >0.65 and FFR ≤0.70 were significantly related to a higher probability of vulnerable plaque after adjustment for each other (OR: 6.75 [95% CI: 2.39-19.1]; 0.001] for PPG >0.65; OR: 4.61 [95% CI: 1.66-12.8]; 0.003 for FFR ≤0.70). When categorizing lesions according to combined PPG >0.65 and FFR ≤0.70, the prevalence of vulnerable plaque was 20.0%, 57.1%, 66.7%, and 88.2% in the order of PPG ≤0.65 and FFR >0.70, PPG ≤0.65 and FFR ≤0.70, PPG >0.65 and FFR >0.70, and PPG >0.65 and FFR ≤0.70 ( for trend < 0.001), respectively. Among low-FFR lesions, the presence of vulnerable plaque can be predicted by PPG combined with FFR without additional anatomical or plaque characteristics. (Precise Percutaneous Coronary Intervention Plan [P3] Study; )

中文翻译：

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功能显着病变中易损斑块的预测因子


除了功能意义外，易损斑块还具有预后意义。本研究的目的是确定功能显着病变中易损斑块的相关特征。在这项跨 5 个国家进行的多中心前瞻性研究中，包括侵入性血流储备分数 (FFR) ≤ 0.80 的患者，总共 95 名具有可用的回拉压力梯度 (PPG) 和冠状动脉计算机断层扫描血管造影和光学相干断层扫描斑块分析的患者进行了分析。易损斑块定义为光学相干断层扫描中存在斑块破裂或薄帽纤维粥样斑块。在 25 项临床特征、侵入性血管造影结果、生理指标和冠状动脉计算机断层扫描血管造影结果中，确定了易损斑块的重要预测因素。平均直径狭窄百分比、FFR 和 PPG 分别为 77.8% ± 14.6%、0.66 ± 0.13 和 0.65 ± 0.13。 53 个病变处 (55.8%) 存在易损斑块。 PPG 和 FFR 被认为是易损斑块的重要预测因子（均为 0.05）。相互调整后，PPG >0.65 和 FFR ≤0.70 与易损斑块的较高概率显着相关（PPG >0.65 的 OR：6.75 [95% CI：2.39-19.1]；0.001]；OR：4.61 [95% CI：1.66-12.8]；FFR ≤0.70 为 0.003）。当根据 PPG >0.65 和 FFR ≤0.70 组合对病变进行分类时，易损斑块的患病率依次为 20.0%、57.1%、66.7% 和 88.2%，按 PPG ≤0.65 和 FFR >0.70、PPG ≤分别为 0.65 和 FFR ≤0.70，PPG >0.65 和 FFR >0.70，以及 PPG >0.65 和 FFR ≤0.70（对于趋势 < 0.001）。 在低 FFR 病变中，可以通过 PPG 结合 FFR 来预测易损斑块的存在，而无需额外的解剖或斑块特征。（精准经皮冠状动脉介入治疗计划[P3]研究；）