2/3 First demonstration that majority of pts with #CMD, but with no evidence of significant #CAD by angiography & #FFR, have significant plaque burden by #IVUS
3/3 Take home message:
✅ Large portion of patients with #CMD who have normal looking coronaries or mild #CAD on angiography, have indeed significant atherosclerosis & plaque burden on #IVUS
✅ These findings have important implications in management & prognosis in #CMD
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#CMD shares similar RFs w epicardial atherosclerosis (traditional ASCVD RFs) & is associated with several biomarkers of inflammation, oxidative stress & coagulation
In our IVUS study:
✅ Most patients with #CMD had significant plaque burden
✅ Patients with #CMD had higher plaque burden & more diffuse atherosclerosis as compared to patients w/o CMD
✅ Angina ➡ poor prognosis
✅ Angina with no obstructive CAD = ⬆ risks of CV events compared to no angina, even after adjusting for traditional RFs & co-morbidities
✅ What Is #CMD & Why Is It Important?
✅ Dx & Risk Stratification of #CMD: Stress Testing & Noninvasive Imaging
✅ Catheter-Based Techniques in Dx of #CMD
✅ Emerging Link Between #CMD & #HFpEF
✅ Phenotype-Based Mngmt of #CMD
🔘 Strengths/Limits of Lesion Specific vs Myocardial Ischemia
🔘 Comparing Dx Accuracy of Tests
🔘 Ischemia Testing in #INOCA
🔘 How to Select Best Noninvasive Test
☢ Issues with proposed #FFR threshold 0.8
☢ Exercise MPI correlates well with FFR but not at 0.8
☢ Benefit of FFR-guided revasc dominantly occurs w/ thresholds <0.8
☢ Quantification of lesion-specific #ischemia insufficient for patient mgmt