Research
Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital
Published

Angiographic characteristics of intermediate stenosis of the left anterior descending artery for determination of lesion significance as identified by fractional flow reserve

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Frequency and Impact of Hyponatremia on All-Cause Mortality in Patients with Aortic Stenosis

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Usefulness of High Sensitivity Troponin T to Predict Long-Term Left Ventricular Dysfunction After ST-Elevation Myocardial Infarction

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Risk of Lifetime Psychiatric Morbidity in Adults With Atrial Septal Defect (from a Nation-Wide Cohort)

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Vitamin K antagonists vs. direct oral anticoagulants after transcatheter aortic valve implantation in atrial fibrillation

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. A computed tomography study of coronary access and coronary obstruction after redo transcatheter aortic valve implantation

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Transcatheter Treatment of Residual Significant Mitral Regurgitation Following TAVR: A Multicenter Registry

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Looking beyond antiplatelet effect of P2Y12 inhibitors: is there anything to see?

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

Previous studies have shown a poor correlation between angiographic assessment of stenosis grade (%) and its functional assessment by fractional flow reserve (FFR). This study aimed to investigate whether a more comprehensive evaluation of the coronary angiogram may contribute to a better identification of flow-limiting stenoses. Coronary angiograms of 1,350 patients (1,883 lesions) were retrospectively analyzed for stenosis grade (eyeballing, %) and matched with FFR values. Angiography-derived optimal cut-off values and intervals delineating the [90% sensitivity-90% specificity] range were 50.8% [42.5-65.0%] for the left main (LM), 62.2% [50.0-72.5%] for the proximal (prox)/mid left anterior descending (LAD) artery, 66.3% [57.5-77.5%] for the prox/mid right coronary artery (RCA), 70.5% [60.0-80.0%] for the prox left circumflex/first obtuse marginal (LCX/OM1), and 71.4% [62.5-82.5%] for the more distal segments. In patients with intermediate LAD lesions, 5 angiographic parameters were identified as independent predictors of flow limitation: (1) a 30-50% lesion prox to the lesion of interest, (2) lesion length >20 mm, (3) distal take-off of all diagonal branches ≥2 mm diameter, (4) "apical wrap" of LAD, and (5) collaterals to an occluded LCX/RCA. Based on these results, a risk score (P20-DAC2) for prediction of flow limitation in intermediate LAD lesions was derived. In conclusion, a comprehensive evaluation of the coronary angiogram-in which besides stenosis grade also other lesion/vessel characteristics are evaluated-can lead to a more accurate identification of functionally significant coronary stenoses.

Original languageEnglish
JournalThe American journal of cardiology
Volume115
Issue number11
Pages (from-to)1475-80
Number of pages6
ISSN0002-9149
DOIs
Publication statusPublished - 1 Jun 2015

    Research areas

  • Coronary Angiography, Coronary Stenosis, Female, Fractional Flow Reserve, Myocardial, Humans, Male, Middle Aged, Retrospective Studies, Severity of Illness Index

ID: 46182261