Impact of hyperaemic stenosis resistance on long-term outcomes of stable angina in the ILIAS Registry

Coen K.M. Boerhout, Mauro Echavarría-Pinto, Guus A. de Waard, Joo Myung Lee, Hernán Mejía-Rentería, Seung Hun Lee, Ji Hyun Jung, Masahiro Hoshino, Hitoshi Matsuo, Maribel Madera-Cambero, Ashkan Eftekhari, Mohamed A. Effat, Tadashi Murai, Koen Marques, Joon Hyung Doh, Evald H. Christiansen, Rupak Banerjee, Chang Wook Nam, Giampaolo Niccoli, Masafumi NakayamaNobuhiro Tanaka, Eun Seok Shin, Marcel A.M. Beijk, Niels van Royen, Paul Knaapen, Javier Escaned, Tsunekazu Kakuta, Bon Kwon Koo, Jan J. Piek, Tim P. van de Hoef, Martijn Meuwissen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: The hyperaemic stenosis resistance (HSR) index was introduced to provide a more comprehensive indicator of the haemodynamic severity of a coronary lesion. HSR combines both the pressure drop across a lesion and the flow through it. As such, HSR overcomes the limitations of the more traditional fractional flow reserve (FFR) or coronary flow reserve (CFR) indices. AIMS: We aimed to identify the diagnostic and prognostic value of HSR and evaluate the clinical implications. METHODS: Patients with chronic coronary syndromes (CCS) and obstructive coronary artery disease were selected from the multicentre ILIAS Registry. For this study, only patients with combined Doppler flow and pressure measurements were included. RESULTS: A total of 853 patients with 1,107 vessels were included. HSR more accurately identified the presence of inducible ischaemia compared to FFR and CFR (area under the curve 0.71 vs 0.66 and 0.62, respectively; p<0.005 for both). An abnormal HSR measurement was an independent and important predictor of target vessel failure at 5-year follow-up (hazard ratio 3.80, 95% confidence interval: 2.12-6.73; p<0.005). In vessels deferred from revascularisation, HSR seems to identify more accurately those vessels that may benefit from revascularisation rather than FFR and/or CFR. CONCLUSIONS: The present study affirms the theoretical advantages of the HSR index for the detection of ischaemia-inducing coronary lesions in a large CCS population.

Original languageEnglish
Pages (from-to)e699-e706
JournalEuroIntervention
Volume20
Issue number11
DOIs
Publication statusPublished - 3 Jun 2024

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