Comprehensive Assessment of Morphometric, Functional, Biomechanical, and Biological Interactions Between Atherosclerotic Plaque and Blood Platelets Within the Stenosed Coronary Artery in Vivo: a Prospective Study

What this Trial Is About

Researchers are investigating how the forces exerted by blood flow, called shear rate and shear stress, relate to blood markers indicating clotting tendencies in people with chronic coronary syndrome and coronary artery narrowing. This study aims to connect these biomechanical forces with plaque characteristics, vessel function, and platelet activity assessed through advanced imaging and blood tests. It is a prospective, single-center observational study involving 105 patients with confirmed coronary stenosis suitable for detailed imaging. Participants undergo several evaluations during angiography, including optical coherence tomography (OCT) to examine plaque details, computational fluid dynamics (CFD) to estimate shear forces and vessel function via vessel fractional flow reserve (vFFR), and blood sampling from coronary arteries to measure platelet activation and inflammatory biomarkers. Some patients will also have proteomic and metabolomic analyses. Comparisons are made between stenosed and non-stenosed vessels within the same individuals. During the study, participants have imaging and blood tests to assess plaque morphology, shear stress distribution, platelet reactivity, and biomarker levels. Researchers will analyze how these factors correlate, focusing on blood sampled both proximally and distally to the stenosis. The primary outcome measures the correlation between shear forces and platelet-derived microvesicles and extracellular vesicles. The study monitors these parameters at baseline, with no long-term treatment or follow-up specified.

Comprehensive Assessment of Morphometric, Functional, Biomechanical and Biological Interactions Between Atherosclerotic Plaque and Platelets Within the Stenosed Coronary Artery