Prediction of Coronary Atherosclerotic Ostial Lesion with a Damping of the Pressure Tracing during Diagnostic Coronary Angiography.
PURPOSE
When performing coronary angiography (CAG), diagnostic catheter intubation to the ostium can cause damping of the pressure tracing. The aim of this study was to determine the predictors of atherosclerotic ostial stenosis in patients showing pressure damping during CAG.


MATERIALS AND METHODS
In total, 2926 patients who underwent diagnostic CAG were screened in this study. Pressure damping was defined as an abrupt decline of the coronary blood pressure with a blunted pulse pressure after engagement of the diagnostic catheter. According to CAG and intravascular ultrasound (IVUS), we divided damped ostia into two groups: atherosclerotic ostial lesion group (true lesion group) and non-atherosclerotic ostium group (false lesion group). Clinical and angiographic characteristics were compared between the two groups.


RESULTS
The overall incidence of pressure damping was 2.3% (68 patients and 76 ostia). Among the pressure damped ostia, 40.8% (31 of 76 ostia) were true atherosclerotic ostial lesions (true lesion group). The true lesion group had more frequent left main ostial damping and more percutaneous coronary interventions (PCIs) performed on non-ostial lesions, compared to the false lesion group. On multivariate logistic regression analysis, left main ostial damping [hazard ratio (HR) 4.11, 95% confidence interval (CI) 1.24-13.67, p=0.021] and PCI on non-ostial lesion (HR 5.34, 95% CI 1.34-21.27, p=0.018) emerged as independent predictors for true atherosclerotic ostial lesions in patients with pressure damping.


CONCLUSION
Left main ostial damping and the presence of a non-ostial atherosclerotic lesion may suggest a significant true atherosclerotic lesion in the coronary ostium.
['Her|Ae Young|AY|', 'Ann|Soe Hee|SH|', 'Singh|Gillian Balbir|GB|', 'Kim|Yong Hoon|YH|', 'Koo|Bon Kwon|BK|', 'Shin|Eun Seok|ES|']
D000368:Aged D017023:Coronary Angiography D003324:Coronary Artery Disease D054059:Coronary Occlusion D023921:Coronary Stenosis D003330:Coronary Vessel Anomalies D003331:Coronary Vessels D005260:Female D006801:Humans D015994:Incidence D008297:Male D008875:Middle Aged D062645:Percutaneous Coronary Intervention D011237:Predictive Value of Tests D016016:Proportional Hazards Models D015641:Radiography, Interventional
ostial lesion coronary angiography Pressure damping intravascular ultrasound