Prediction of Coronary Atherosclerotic Ostial Lesion with a Damping of the Pressure Tracing during Diagnostic Coronary Angiography.
- Author:
Ae Young HER
1
;
Soe Hee ANN
;
Gillian Balbir SINGH
;
Yong Hoon KIM
;
Bon Kwon KOO
;
Eun Seok SHIN
Author Information
- Publication Type:Original Article ; Comparative Study ; Research Support, Non-U.S. Gov't
- Keywords: Pressure damping; ostial lesion; coronary angiography; intravascular ultrasound
- MeSH: Aged; *Coronary Angiography; Coronary Artery Disease/etiology/*radiography; Coronary Occlusion/diagnosis/*therapy; Coronary Stenosis/etiology/*radiography; Coronary Vessel Anomalies/radiography; Coronary Vessels/*pathology; Female; Humans; Incidence; Male; Middle Aged; Percutaneous Coronary Intervention/adverse effects/methods; Predictive Value of Tests; Proportional Hazards Models; Radiography, Interventional
- From:Yonsei Medical Journal 2016;57(1):58-63
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: When performing coronary angiography (CAG), diagnostic catheter intubation to the ostium can cause damping of the pressure tracing. The aim of this study was to determine the predictors of atherosclerotic ostial stenosis in patients showing pressure damping during CAG. MATERIALS AND METHODS: In total, 2926 patients who underwent diagnostic CAG were screened in this study. Pressure damping was defined as an abrupt decline of the coronary blood pressure with a blunted pulse pressure after engagement of the diagnostic catheter. According to CAG and intravascular ultrasound (IVUS), we divided damped ostia into two groups: atherosclerotic ostial lesion group (true lesion group) and non-atherosclerotic ostium group (false lesion group). Clinical and angiographic characteristics were compared between the two groups. RESULTS: The overall incidence of pressure damping was 2.3% (68 patients and 76 ostia). Among the pressure damped ostia, 40.8% (31 of 76 ostia) were true atherosclerotic ostial lesions (true lesion group). The true lesion group had more frequent left main ostial damping and more percutaneous coronary interventions (PCIs) performed on non-ostial lesions, compared to the false lesion group. On multivariate logistic regression analysis, left main ostial damping [hazard ratio (HR) 4.11, 95% confidence interval (CI) 1.24-13.67, p=0.021] and PCI on non-ostial lesion (HR 5.34, 95% CI 1.34-21.27, p=0.018) emerged as independent predictors for true atherosclerotic ostial lesions in patients with pressure damping. CONCLUSION: Left main ostial damping and the presence of a non-ostial atherosclerotic lesion may suggest a significant true atherosclerotic lesion in the coronary ostium.
