Abstract 11687: Cumulative Effect of Lesion Morphology and Location on the Functional Significance in Patient With Intermediate Stenotic Coronary Lesions
Introduction: Although identifying functional ischemia is important to decide revascularization, angiographic assessment alone is challenging in intermediate coronary stenosis. Previous studies have reported lesion-specific characteristics affected fractional flow reserve (FFR) values. However, the relationship between multiple lesion morphologies and FFR values has not been fully evaluated yet.
Hypothesis: We hypothesized that cumulative impact of lesion complexity and lesion location affected FFR value as well as the degree of stenosis in intermediate stenotic coronary lesions.
Methods: A total of 109 consecutive patients with 136 intermediate stenotic lesions (visual estimation 40%< diameter stenosis <70%) were assessed by quantitative coronary angiography, lesion-specific characteristics, and fractional flow reserve (FFR). According to the number of morphologies, lesion complexity was classified into 3 groups (mild-complex: 0 or 1 morphology, moderate-complex: 2 or 3 morphologies, and severe-complex: 4–6 morphologies), and their functional severity were evaluated. Functional significance was defined as an FFR<0.80.
Results: Of 136 lesions, 51% were located in the left anterior descending artery (LAD), 31% were located in the proximal segment, and functional significance was observed in 47%. FFR showed significant differences among the 3 lesion complexities group (0.84±0.10 vs. 0.79±0.10 vs. 0.73±0.07, p<0.01). Lesions located in the proximal and distal LAD had significantly lower FFR than those in the distal non-LAD (p<0.01 and p<0.01, respectively). LAD lesions, moderate- and severe-complex lesions, and DS were independently associated with functional significance (odds ratio [OR]: 5.65, 95% confidence interval [CI]: 2.50, 12.80, p<0.01; OR: 2.96, 95% CI: 1.30, 6.72, p<0.01; OR: 7.11, 95% CI: 1.25, 40.37, p=0.03, and OR: 2.65, 95% CI: 1.04, 6.72, p=0.04, respectively).
Conclusions: FFR was affected by lesion location as well as the degree of diameter stenosis. In addition, lesion complexity assessed by cumulative lesion morphology was related to the degree of functional severity in intermediate stenotic coronary lesions.
Author Disclosures: H. Takashima: None. K. Waseda: None. M. Gosho: None. A. Kurita: None. H. Ando: None. S. Sakurai: None. S. Kumagai: None. A. Suzuki: None. T. Amano: None.
- © 2014 by American Heart Association, Inc.