Natural History of Coronary Atherosclerosis Based on Multimodal Imaging and Physiological Fusion Techniques (NASCENT)

What this Trial Is About

Researchers are investigating the predictive value of radial wall strain (RWS), a measure derived from coronary angiograms, for the progression of coronary artery lesions compared to lesion vulnerability assessed by optical coherence tomography (OCT). The study focuses on patients who have had an acute myocardial infarction within the past 45 days, aiming to determine if RWS can identify vulnerable plaques and predict disease progression over one year. This prospective, multicenter observational study seeks to enhance methods for detecting high-risk coronary lesions. The study computes the maximum radial wall strain (RWSmax) as the maximum deformation of the coronary artery lumen diameter during the cardiac cycle, expressed as a percentage. Participants undergo coronary angiography and potentially interventional treatment to evaluate lesions with 30%-80% diameter stenosis that do not restrict blood flow. The study compares the ability of RWSmax (using a threshold of 13%) and OCT to predict lesion progression defined as a 20% or greater increase in artery narrowing at one year. Participants will be monitored over the course of one year, with assessments including quantitative coronary angiography (QCA) to measure lesion progression. Secondary outcomes include major adverse cardiac events, all-cause death, new myocardial infarction, unplanned revascularization, stent thrombosis, and various imaging and physiological parameters measured at 1, 2, and 3 years. The study involves repeated imaging and physiological evaluations to understand lesion behavior and disease progression in coronary artery disease patients.

Natural History of Coronary Atherosclerosis