Prognostic significance of thermodilution-derived coronary flow capacity in patients with deferred revascularisation

Area of Science:

• Cardiology
• Interventional Cardiology
• Diagnostic Imaging

Background:

• Stable coronary artery disease (CAD) management involves assessing ischaemia risk.
• Deferred revascularisation decisions require accurate prognostic tools.
• Current risk stratification methods may not fully capture prognostic information.

Purpose of the Study:

• To evaluate the prognostic value of thermodilution-derived coronary flow capacity (T-CFC) in patients with stable CAD.
• To determine if T-CFC improves risk prediction for adverse cardiac events in patients undergoing deferred revascularisation.

Main Methods:

• 308 lesions in 308 patients with stable CAD and deferred revascularisation were analyzed.
• Patients were stratified based on T-CFC measurements (ischaemic vs. non-ischaemic).
• Clinical outcomes (vessel-oriented composite endpoints - VOCE, major adverse cardiac events - MACE) were assessed.

Main Results:

• Ischaemic T-CFC was identified in 28.6% of lesions.
• Lesions with ischaemic T-CFC showed significantly higher risks of VOCE and MACE.
• T-CFC significantly improved risk prediction models, outperforming fractional flow reserve and coronary flow reserve in certain contexts.

Conclusions:

• Thermodilution-derived coronary flow capacity (T-CFC) offers significant prognostic value.
• T-CFC enhances risk stratification for adverse events in stable CAD patients with deferred revascularisation.
• This measurement provides incremental predictive ability beyond clinical factors and other physiological indices.