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

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 #1Reading #2Kappa (k)±SEPre-Procedural (%)Total Occlusion/Eccentricity3.0/583.0/611.00/0.750/0.06Angulation/Thrombus18/9.017/6.00.72/06.80.08/0.12Tortuosity/Calcification3.0/5.31.5/8.30.66/0.640.22/0.13Post-Procedural (%)Any Dissection/Staining8.6/2.68.6/1.70.89/0.800.08/0.20TIMI <3/Spasm5.1/3.44.3/1.70.71/0.660.16/0.23Ectasia/Lumen Irregularity6.9/6.05.2/6.00.55/0.540.17/0.17Thrombus/Haziness2.6/12.02.6/15.40.32/0.280.25/0.12Quantitative AngiographyReading #1Reading #2Δ±SDR/rReference Diameter mm2.77±0.642.78±0.64017±0.160.93/0.93Pre-MLD, mm087±0.680.91±0.660.19±0180.93/0.93Pre-% Diameter Stenosis69±2068±206±60.91/0.91Final- MLD, mm2.23±0.852.13±0.830.22±0.220.93/0.94Final-% Diameter Stenosis22±2125±217±70.88/0.90We conclude thatCore 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