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

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Angiographic characteristics of intermediate stenosis of the left anterior descending artery for determination of lesion significance as identified by fractional flow reserve. / Biasco, Luigi; Pedersen, Frants; Lønborg, Jacob; Holmvang, Lene; Helqvist, Steffen; Saunamäki, Kari; Kelbaek, Henning; Clemmensen, Peter; Olivecrona, Göran K; Jørgensen, Erik; Engstrøm, Thomas; De Backer, Ole.

In: AM J CARDIOL, Vol. 115, No. 11, 01.06.2015, p. 1475-1480.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Biasco, L, Pedersen, F, Lønborg, J, Holmvang, L, Helqvist, S, Saunamäki, K, Kelbaek, H, Clemmensen, P, Olivecrona, GK, Jørgensen, E, Engstrøm, T & De Backer, O 2015, 'Angiographic characteristics of intermediate stenosis of the left anterior descending artery for determination of lesion significance as identified by fractional flow reserve', AM J CARDIOL, vol. 115, no. 11, pp. 1475-1480. https://doi.org/10.1016/j.amjcard.2015.02.047

APA

Biasco, L., Pedersen, F., Lønborg, J., Holmvang, L., Helqvist, S., Saunamäki, K., Kelbaek, H., Clemmensen, P., Olivecrona, G. K., Jørgensen, E., Engstrøm, T., & De Backer, O. (2015). Angiographic characteristics of intermediate stenosis of the left anterior descending artery for determination of lesion significance as identified by fractional flow reserve. AM J CARDIOL, 115(11), 1475-1480. https://doi.org/10.1016/j.amjcard.2015.02.047

Vancouver

Biasco L, Pedersen F, Lønborg J, Holmvang L, Helqvist S, Saunamäki K et al. Angiographic characteristics of intermediate stenosis of the left anterior descending artery for determination of lesion significance as identified by fractional flow reserve. AM J CARDIOL. 2015 Jun 1;115(11):1475-1480. https://doi.org/10.1016/j.amjcard.2015.02.047

Bibtex

@article{5374151e163a4ec9b736fa272a929582,
title = "Angiographic characteristics of intermediate stenosis of the left anterior descending artery for determination of lesion significance as identified by fractional flow reserve",
abstract = "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. ",
keywords = "Coronary Angiography, Coronary Stenosis/diagnostic imaging, Female, Fractional Flow Reserve, Myocardial, Humans, Male, Middle Aged, Retrospective Studies, Severity of Illness Index",
author = "Luigi Biasco and Frants Pedersen and Jacob L{\o}nborg and Lene Holmvang and Steffen Helqvist and Kari Saunam{\"a}ki and Henning Kelbaek and Peter Clemmensen and Olivecrona, {G{\"o}ran K} and Erik J{\o}rgensen and Thomas Engstr{\o}m and {De Backer}, Ole",
note = "Copyright {\textcopyright} 2015 Elsevier Inc. All rights reserved.",
year = "2015",
month = jun,
day = "1",
doi = "10.1016/j.amjcard.2015.02.047",
language = "English",
volume = "115",
pages = "1475--1480",
journal = "AM J CARDIOL",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "11",

}

RIS

TY - JOUR

T1 - Angiographic characteristics of intermediate stenosis of the left anterior descending artery for determination of lesion significance as identified by fractional flow reserve

AU - Biasco, Luigi

AU - Pedersen, Frants

AU - Lønborg, Jacob

AU - Holmvang, Lene

AU - Helqvist, Steffen

AU - Saunamäki, Kari

AU - Kelbaek, Henning

AU - Clemmensen, Peter

AU - Olivecrona, Göran K

AU - Jørgensen, Erik

AU - Engstrøm, Thomas

AU - De Backer, Ole

N1 - Copyright © 2015 Elsevier Inc. All rights reserved.

PY - 2015/6/1

Y1 - 2015/6/1

N2 - 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.

AB - 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.

KW - Coronary Angiography

KW - Coronary Stenosis/diagnostic imaging

KW - Female

KW - Fractional Flow Reserve, Myocardial

KW - Humans

KW - Male

KW - Middle Aged

KW - Retrospective Studies

KW - Severity of Illness Index

U2 - 10.1016/j.amjcard.2015.02.047

DO - 10.1016/j.amjcard.2015.02.047

M3 - SCORING: Journal article

C2 - 25857401

VL - 115

SP - 1475

EP - 1480

JO - AM J CARDIOL

JF - AM J CARDIOL

SN - 0002-9149

IS - 11

ER -