934-23 Reproducibility of Qualitative and Quantitative Angiographic Findings in the New Approaches to Coronary Intervention (NACI) Registry

Abstract

To assess the reliability of qualitative morphologic and quantitative angiographic measurements from the NACI Registry Angiographic Core Laboratory, repeat analysis of 135 lesions was performed >2 months after the initial analysis. Pre- and post-procedural lesion morphology was evaluated by a trained technician utilizing standardized criteria; all readings were then reviewed at a separate sitting by an expert panel. Quantitative angiographic analysis was performed using contrast-filled guiding catheters and a validated edge-detection system (ImageComm). Reproducibility for lesion morphology was graded as poor-slight (k = 0.0-0.2), fair (k = 0.21-0.40), moderate (k = 0.41-0.60), substantial (k = 0.61-0.80), and almost perfect (k = 0.81-1.00). lntraclass (R) and Pearson (r) correlation coefficients are provided for quantitative angiographic measurements. Reading #1 Reading #2 Kappa (k) ±SE Pre-Procedural (%) Total Occlusion/Eccentricity 3.0/58 3.0/61 1.00/0.75 0/0.06 Angulation/Thrombus 18/9.0 17/6.0 0.72/06.8 0.08/0.12 Tortuosity/Calcification 3.0/5.3 1.5/8.3 0.66/0.64 0.22/0.13 Post-Procedural (%) Any Dissection/Staining 8.6/2.6 8.6/1.7 0.89/0.80 0.08/0.20 TIMI <3/Spasm 5.1/3.4 4.3/1.7 0.71/0.66 0.16/0.23 Ectasia/Lumen Irregularity 6.9/6.0 5.2/6.0 0.55/0.54 0.17/0.17 Thrombus/Haziness 2.6/12.0 2.6/15.4 0.32/0.28 0.25/0.12 Quantitative Angiography Reading #1 Reading #2 Δ ± SD R/r Reference Diameter mm 2.77 ± 0.64 2.78 ± 0.64 017 ± 0.16 0.93/0.93 Pre-MLD, mm 087 ± 0.68 0.91 ± 0.66 0.19 ± 018 0.93/0.93 Pre-% Diameter Stenosis 69 ± 20 68 ± 20 6 ± 6 0.91/0.91 Final- MLD, mm 2.23 ± 0.85 2.13 ± 0.83 0.22 ± 0.22 0.93/0.94 Final-% Diameter Stenosis 22 ± 21 25 ± 21 7 ± 7 0.88/0.90 We conclude that Core Laboratory measurements of pre-procedural morphology, post-procedural dissection (±staining), and quantitative angiographic indices are highly reproducible in the NACI Registry, although reliability is lower for selected findings, including post-procedural thrombus and haziness.