ArticleEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology2024
Vulnerable plaque features and adverse events in patients with diabetes mellitus: a post hoc analysis of the COMBINE OCT-FFR trial.
Article in EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02989740 (Combined Optical Coherence Tomography Morphologic and Fractional Flow Reserve Hemodynamic Assessment of Non-Culprit Lesions to Better Predict Adverse Event Outcomes in Diabetes Mellitus Patients. COMBINE), which is not on this map. Cited by 17 papers.
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The trial behind it
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Combined Optical Coherence Tomography Morphologic and Fractional Flow Reserve Hemodynamic Assessment of Non-Culprit Lesions to Better Predict Adverse Event Outcomes in Diabetes Mellitus Patients. COMBINE (OCT-FFR) Prospective Register
Who cites it
17 citing papers in PubMed.
- Outcomes of Patients With High-Risk Plaques Treated With a Bioresorbable Magnesium Scaffold: Insights From the BIOMAG-I Study.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026Trial
- Molecular Mechanisms Underlying the Comorbidity of Type 2 Diabetes Mellitus and Coronary Artery Disease: from Insulin Resistance and Inflammation to Endothelial Dysfunction and Therapeutic Implications.Cardiovascular drugs and therapy · 2026Review
- Impact of Diabetes on Coronary Plaque Stabilization With Evolocumab: Insights From the YELLOW III Trial.Cardiovascular drugs and therapy · 2026Article
- Association Between Cardiovascular Risk Factors and Pan-Coronary Plaque Burden, Phenotype, and Vulnerability: A 3-Vessel Imaging Study.JACC. Advances · 2026Article
- Relationship between hs-CRP-triglyceride glucose index and coronary plaque morphology: insights from optical coherence tomography.Diabetology & metabolic syndrome · 2026Article
- The impact of pullback measurement on treatment decision in significant coronary artery disease: Insights from a retrospective multicentric study.International journal of cardiology. Heart & vasculature · 2026Article
- Nanocarrier SIroliMus-coated balloon-based percutaneous coronary intervention (PCI) versus drug-eluting stent (DES)-onLy PCI in patients with diabetes mellitus.Cardiovascular diabetology · 2026Observational
- Intracoronary Imaging for the Management of Vulnerable Plaques.Journal of clinical medicine · 2026Review
- The Prognostic Value of Different Patterns of Neoatherosclerosis and Treatment Modality in Patients With Coronary In-Stent Restenosis.Cardiovascular therapeutics · 2026Article
- Polarization-sensitive optical coherence tomography-based fully-automated volumetric coronary fibrous cap characterization.European heart journal. Imaging methods and practice · 2026Article
- Prognostic Role and Therapeutic Implications of Intravascular Optical Coherence Tomography Detected Coronary Plaque Microstructures in Patients with Coronary Artery Disease.Journal of clinical medicine · 2025Review
- Current status and mechanistic insights into nontarget coronary lesions in patients with diabetes and early abnormal glucose metabolism.World journal of diabetes · 2025Review
- In Vivo Optical Coherence Tomography Detection of Repetitive Plaque Erosion Leading to Healed Plaques and Lesion Progression.JACC. Case reports · 2024Article
- Reply: Identifying vulnerable coronary atherosclerotic plaques: from theory to practice.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2024Article
- Letter: Identifying vulnerable coronary atherosclerotic plaques: from theory to practice.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2024Article
- Computed Tomography Angiography Identified High-Risk Coronary Plaques: From Diagnosis to Prognosis and Future Management.Diagnostics (Basel, Switzerland) · 2024Review
- Are we ripe for preventive percutaneous coronary interventions?REC, interventional cardiologyArticle
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThin-cap fibroatheroma (TCFA) lesions are associated with a high risk of future major adverse cardiovascular events. However, the impact of other optical coherence tomography-detected vulnerability features (OCT-VFs) and their interplay with TCFA in predicting adverse events remains unknown.
aimsWe aimed to evaluate the individual as well as the combined prognostic impact of OCT-VFs in predicting the incidence of the lesion-oriented composite endpoint (LOCE) in non-ischaemic lesions in patients with diabetes mellitus (DM).
methodsCOMBINE OCT-FFR (ClinicalTrials.gov: NCT02989740) was a prospective, double-blind, international, natural history study that included DM patients with ≥1 non-culprit lesions with a fractional flow reserve>0.80 undergoing systematic OCT assessment. OCT-VFs included the following: TCFA, reduced minimal lumen area (r-MLA), healed plaque (HP), and complicated plaque (CP). The primary endpoint, LOCE - a composite of cardiac mortality, target vessel myocardial infarction, or clinically driven target lesion revascularisation up to 5 years - was analysed according to the presence of these OCT-VFs, both individually and in combination.
resultsTCFA, r-MLA, HP and CP were identified in 98 (25.3%), 190 (49.0%), 87 (22.4%), and 116 (29.9%) patients, respectively. The primary endpoint rate increased progressively from 6.3% to 55.6% (hazard ratio 15.2, 95% confidence interval: 4.53-51.0; p<0.001) in patients without OCT-VFs as compared to patients with concomitant HP, r-MLA, CP, and TCFA. The coexistence of TCFA with other OCT-VFs resulted in an increased risk of the LOCE at 5 years.
conclusionsIn DM patients with non-ischaemic lesions, TCFA was the strongest predictor of future LOCE events. However, lesions that present additional OCT-VFs are associated with a higher risk of adverse events than OCT-detected TCFA alone. Further randomised studies are warranted to confirm these findings and their potential clinical implications.
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