Comparison of quantitative calcium parameters between optical coherence tomography and invasive coronary angiography

Abstract

ABSTRACT Introduction and objectives: Former studies have associated the severity of calcified plaques (CP) on the invasive coronary angiography (ICA) with a limited number of optical coherence tomography (OCT) measurements. The objective of this study was to describe the correlation between an extended and comprehensive set of OCT measurements and the severity of calcifications as seen on the ICA. Methods: We retrospectively studied 75 patients (75 lesions) who underwent ICA and, concurrently, OCT imaging at a single institution. The OCT was performed before the percutaneous coronary intervention and after the administration of intracoronary nitroglycerine. The coronary artery calcium was scored using a three-tier classification system on the ICA. Maximum calcium angle, area, maximum thickness, length of calcium, and calcium depth were assessed on the OCT. Results: The ICA detected fewer CP lesions compared to the OCT (N = 69; 92%), all cases of positive ICA were detected by the OCT (N = 30; 100%). The OCT did not find any positive lesions in negative angiographic lesions (N = 6; 100%). The sensitivity of the ICA was 43.5% (95%CI, 0.32-0.56) and its specificity, 100% (95%CI, 0.52-1.0). In most cases, as calcium angle, thickness, and area increased on the OCT so did the calcium severity of the lesions on the angiography. Conclusions: Compared to the OCT, the ICA has a low sensitivity and a high specificity in the detection of calcified plaques. As calcium angle, thickness, area, and length increased on the OCT so did the number of angio-defined lesions of severe CP.

Keywords

• Tomography
• Optical coherence tomography
• Invasive coronary angiography
• Percutaneous coronary intervention
• Calcification