Temporal changes in coronary plaque as assessed by an artificial intelligence–based optical coherence tomography: from the first-in-human trial on DREAMS 3G scaffold

Hector M. Garcia-Garcia, Ron Waksman, Gebremedhin D. Melaku, Mohil Garg, Solomon Beyene, Adrian Wlodarczak, Ajay Kerai, Molly B. Levine, René J. van der Schaaf, Jan Torzewski, Bert Ferdinande, Javier Escaned, Juan F. Iglesias, Johan Bennett, Gabor G. Toth, Michael Joner, Ralph Toelg, Marcus Wiemer, Göran Olivecrona, Paul VermeerschMichael Haude

Research output: Contribution to journalArticlepeer-review

Abstract

Aims The aim of the study is to assess the impact of the baseline plaque composition on the DREAMS 3G luminal late loss and to compare the serial plaque changes between baseline and 6 and 12 months (M) follow-up. Methods A total of 116 patients were enrolled in the BIOMAG-I trial. Patients were imaged with optical coherence tomography and results (OCT) pre- and post-DREAMS 3G implantation and at 6 and 12 M. OCTPlus software uses artificial intelligence to assess composition (i.e. lipid, calcium, and fibrous tissue) of the plaque. The differences between the OCT-derived minimum lumen area (MLA) post-percutaneous coronary intervention and 12 M were grouped into three terciles. Patients with larger MLA differences at 12 M (P = 0.0003) had significantly larger content of fibrous tissue at baseline. There was a reduction of 24.8% and 20.9% in lipid area, both P < 0.001, between the pre-DREAMS 3G OCT and the 6 and 12 M follow-up. Conversely, the fibrous tissue increased by 48.4% and 36.0% at 6 and 12 M follow-up, both P < 0.001. Conclusion The larger the fibrous tissue in the lesion at baseline, the larger the luminal loss seen at 6 and 12 M. Following the implantation of DREAMS 3G, favourable healing of the vessel coronary wall occurs as shown by a decrease in the lipid area and an increase in fibrous tissue.

Original languageEnglish
Pages (from-to)491-497
Number of pages7
JournalEuropean Heart Journal Cardiovascular Imaging
Volume25
Issue number4
DOIs
StatePublished - 1 Apr 2024

Keywords

  • bioresorbable stent
  • de novo coronary lesion
  • drug-eluting stent
  • minimum lumen area
  • optical coherence tomography
  • percutaneous coronary intervention

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