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

Summary

The main objective of the present study is to verify, in vivo, whether shear forces computed solely based on coronary angiography and computational fluid dynamics (CFD) techniques are associated with the biomarkers indicating the prothrombotic tendency of circulating blood in situ - distally and proximally to the coronary stenosis. The study will prospectively assess the relationship between i) the value and distribution of shear rate and shear stress (SS) estimated using three-dimensional angiography and CFD techniques, and ii) atherosclerotic plaque characteristics as assessed by optical coherence tomography (OCT), iii) functional parameters of diseased vessels assessed by vessel fractional flow reserve (vFFR), and iv) in situ platelet activation, as expressed by platelet-derived microvesicles (pMVs) and small extracellular vesicles (sEVs), platelet aggregometry and other serum prothrombotic or inflammatory biomarkers sampled within the coronary artery.

Eligibility

Inclusion Criteria:

* Chronic coronary syndrome
* Angiographically confirmed coronary stenosis (30% - 90%)
* Amenable to OCT imaging

Exclusion Criteria:

* Cardiogenic shock
* ST-segment elevation or non-ST-segment elevation myocardial infarction
* Active bleeding
* Left main coronary artery disease
* Multivessel disease
* Lesions located at a distance ≤3 mm from the ostium of the vessel
* Thrombocytopenia
* Previous coronary artery bypass grafting
* Previous coronary intervention with stent implantation or balloon angioplasty
* Previous use of novel oral anticoagulants or vitamin K antagonists

Conditions3

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