Prognostic Value of Optical Flow Ratio among Patients with Coronary Artery Disease after Percutaneous Coronary Treatment: A Hospital-Based Retrospective Cohort Investigation

Abstract

Objective: The goal of this study was to examine the prognostic performance of optical flow ratio (OFR) among patients with coronary artery disease (CAD) after percutaneous coronary intervention (PCI). Methods: We recruited patients with CAD undergoing optical coherence tomography (OCT)-directed PCI between January 2019 and June 2021 for our single-center, hospital-based, retrospective cohort investigation. We assessed the link between post-PCI OFR and major adverse cardiovascular events (MACE) via multivariate Cox regression analysis. Results: Receiver operating characteristic analysis revealed that the best post-PCI OFR threshold for MACE was 0.91, and introduction of OFR into the baseline profile and OCT results markedly enhanced MACE identification after PCI. On the basis of survival curves, patients with OFR ≤0.91 (P < 0.001) and thin-cap fibroatheroma (TCFA) (P = 0.007) exhibited higher MACE incidence, and myocardial infarction (MI) incidence was considerably greater among patients with OFR ≤0.91 (P < 0.001), compared with OFR >0.91. Multivariate Cox regression analysis suggested that OFR ≤0.91 (hazard ratio [HR]: 3.60; 95% confidence interval [CI]: 1.24–10.44; P = 0.019), and TCFA (HR: 3.63; 95% CI: 1.42–9.20; P = 0.007) were independent risk factors for MACE, and OFR ≤0.91 was independently associated with MI (HR: 14.64; 95% CI: 3.27–65.54; P < 0.001). Conclusion: OFR after PCI is an independent MACE bio-indicator among patients with CAD. Adding OFR to post-PCI OCT results may potentially enhance MACE prediction.