Investigator-initiated, international, multicentre, observational study with two cohorts. The two study cohorts will be: Cohort A: to understand if the local blood flow patterns (associated with low WSS), as evaluated by computational fluid dynamic tools from combined angiographic and OCT invasive images, may better predict the clinical outcome of patients with bifurcated coronary lesions treated by PCI. Cohort B: to understand if the local blood flow patterns (associated with low WSS), as evaluated by computational fluid dynamic tools from combined angiographic and OCT invasive images, may better predict the clinical outcome of patients with sub-critical bifurcated lesions managed conservatively. Coronary angiography and OCT images will be combined to obtain a three-dimensional model of the diseased coronary vessels that will be used to calculate the local blood flow patterns and the time-averaged WSS at the bifurcated lesion level by using computational fluid dynamics software. Baseline (in patients both managed conservatively and treated by PCI) and post-PCI (in patients treated by PCI) images will be processed.
Study Type
OBSERVATIONAL
Enrollment
300
Coronary angiography and OCT images will be combined to obtain a three-dimensional model of the diseased coronary vessels that will be used to calculate the local blood flow patterns and the arterial time-averaged wall shear stress at the bifurcated lesion level
Policlinico A. Gemelli. Università Cattolica del Sacro Cuore
Roma, Italy
Target bifurcation failure (TBF)
\- Target bifurcated lesion-related major adverse coronary event (MACE) defined as the composite of: * cardiac death * myocardial infarction (MI) not clearly related with another vessel * target vessel revascularization (TVR)
Time frame: 1,6,12,18,24 and 36 months
Target vessel failure
\- In the absence of target bifurcated lesion-related MACE, target bifurcated lesion angiographic failure defined, in patients treated by PCI, as: \> 50% restenosis on the main vessel (MV) or TIMI (Thrombolysis In Myocardial Infarction) flow \< 3 on the side branch (SB) at angiography eventually performed during the clinical course.
Time frame: 1,6,12,18,24 and 36 months
Bifurcated lesion angiographic failure
* Cardiac death * MI * TVR * Definite or probable stent thrombosis
Time frame: 1,6,12,18,24 and 36 months
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