Diabetics with thin-cap fibroatheroma on OCT at high CV risk despite negative FFR: Study

The results of the study are as follows:

• Among 550 patients enrolled, 390 (81%) patients had ≥1 FFR-negative lesion. Among FFR-negative patients, 98 (25%) were TCFA positive and 292 (75%) were TCFA negative.
• The incidence of the primary endpoint was 13.3% and 3.1% in TCFA-positive vs. TCFA-negative groups, respectively.
• The Cox regression multivariable analysis identified TCFA as the strongest predictor of major adverse clinical events (MACE)

Thus, the researchers concluded that among Diabetes mellitus patients with ≥1 FFR-negative lesions, TCFA-positive patients represented 25% of this population and were associated with a five-fold higher rate of MACE despite the absence of ischaemia. This discrepancy between the impact of vulnerable plaque and ischaemia on future adverse events may represent a paradigm shift for coronary artery disease risk stratification in Diabetes mellitus patients.

Reference:

Thin-cap fibroatheroma predicts clinical events in diabetic patients with normal fractional flow reserve: the COMBINE OCT–FFR trial by Kedhi, E et. al published in the European Heart Journal.

https://doi.org/10.1093/eurheartj/ehab433