{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:04:27Z","timestamp":1792785867214,"version":"4.5.0"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"aohiko Miyata\u2013Asahi Intecc Foundation"},{"name":"Medical Technology and Research"},{"DOI":"10.13039\/501100003348","name":"Fukuda Foundation for Medical Technology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003348","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Shimadzu Science Foundation","id":[{"id":"https:\/\/ror.org\/04w9pag91","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Astellas Foundation for Research"},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP23K15178"],"award-info":[{"award-number":["JP23K15178"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Fractional flow reserve (FFR) and non-hyperaemic pressure ratios (NHPRs) frequently yield discordant results in clinical practice, yet the mechanisms underlying this mismatch remain uncertain. Plaque composition has been suggested to influence FFR, raising the possibility that discordance reflects the features of lipid-rich plaque (LRP). This study aimed to investigate whether physiological discordance between FFR and NHPR is associated with increased lipid burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We retrospectively analysed 217 intermediate coronary lesions from 189 patients who underwent FFR, NHPR, and near-infrared spectroscopy with intravascular ultrasound imaging. Lesions were classified using established cut-offs for FFR (0.80) and NHPR (0.89). Lipid burden was quantified by the maximum lipid core burden index within any 4-mm segment (maxLCBI4mm). Lipid-rich plaque was defined as maxLCBI4mm &amp;gt; 400. The clinical endpoint was 3-year target vessel failure (TVF). Physiological discordance occurred in 24.0% of lesions, predominantly as an FFR+\/NHPR\u2212 pattern (19.8%). FFR was independently associated with maxLCBI4mm [\u03b2, 65.2; 95% confidence interval (CI), 29.0\u2013101.5; P &amp;lt; 0.001], whereas NHPR was not (\u03b2, 16.5; 95% CI, \u221215.9 to 49.0; P = 0.316). The FFR+\/NHPR\u2212 group demonstrated the highest maxLCBI4mm (525 \u00b1 201) and the greatest prevalence of LRP (65.1%; both P &amp;lt; 0.001). In multivariable analysis, the FFR+\/NHPR\u2212 pattern independently predicted LRP [adjusted odds ratio, 6.12; 95% CI, 1.20\u201331.28; P = 0.030]. TVF occurrences did not differ significantly across physiological groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>FFR+\/NHPR\u2212 lesions exhibit markedly greater lipid burden, suggesting that hyperaemia-based indices better capture plaque vulnerability than resting physiology. This pattern may serve as a marker of plaque vulnerability, suggesting that deferral of FFR+\/NHPR\u2212 lesions could warrant caution given their higher lipid burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjopen\/oeag155","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T19:34:54Z","timestamp":1789673694000},"source":"Crossref","is-referenced-by-count":0,"title":["Association of physiological discordance between fractional flow reserve and non-hyperaemic pressure ratios with lipid-rich plaque burden"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6392-8381","authenticated-orcid":false,"given":"Hirohiko","family":"Aikawa","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center , 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565 ,","place":["Japan"]},{"name":"Senri Critical Care Medical Center, Saiseikaisenri Hospital , 1-1-6 Tsukumodai, Suita, Osaka 565-0862 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5162-4783","authenticated-orcid":false,"given":"Kota","family":"Murai","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center , 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6307-5593","authenticated-orcid":false,"given":"Yu","family":"Kataoka","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center , 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3100-574X","authenticated-orcid":false,"given":"Yuriko","family":"Nakaoku","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center , 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0100-376X","authenticated-orcid":false,"given":"Soshiro","family":"Ogata","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center , 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1381-7629","authenticated-orcid":false,"given":"Kentaro","family":"Mitsui","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center , 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8961-2390","authenticated-orcid":false,"given":"Takamasa","family":"Iwai","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center , 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0710-0870","authenticated-orcid":false,"given":"Kenichiro","family":"Sawada","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center , 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7471-3375","authenticated-orcid":false,"given":"Hideo","family":"Matama","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center , 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1301-3906","authenticated-orcid":false,"given":"Hiroyuki","family":"Miura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center , 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1393-4270","authenticated-orcid":false,"given":"Satoshi","family":"Honda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center , 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2706-4317","authenticated-orcid":false,"given":"Masashi","family":"Fujino","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center , 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuichi","family":"Yoneda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center , 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9034-3976","authenticated-orcid":false,"given":"Kazuhiro","family":"Nakao","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center , 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3999-8536","authenticated-orcid":false,"given":"Kensuke","family":"Takagi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center , 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9009-7234","authenticated-orcid":false,"given":"Yasuhide","family":"Asaumi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center , 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0639-0949","authenticated-orcid":false,"given":"Kunihiro","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center , 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5372-4932","authenticated-orcid":false,"given":"Teruo","family":"Noguchi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center , 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"2026100816021984000_oeag155-B1","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1253\/circj.CJ-19-1131","article-title":"JCS 2018 guideline on diagnosis of chronic coronary heart diseases","volume":"85","author":"Yamagishi","year":"2021","journal-title":"Circ J"},{"key":"2026100816021984000_oeag155-B2","first-page":"e18","article-title":"2021 ACC\/AHA\/SCAI guideline for coronary artery revascularization: a report of the American College of Cardiology\/American Heart Association joint committee on clinical practice guidelines","volume":"145","author":"Lawton","year":"2022","journal-title":"Circulation"},{"key":"2026100816021984000_oeag155-B3","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1093\/eurheartj\/ehy394","article-title":"2018 ESC\/EACTS guidelines on myocardial revascularization","volume":"40","author":"Neumann","year":"2019","journal-title":"Eur Heart J"},{"key":"2026100816021984000_oeag155-B4","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1016\/j.jcin.2025.05.032","article-title":"Outcomes of lesions with discordance between FFR and nonhyperemic pressure ratios","volume":"18","author":"Ha","year":"2025","journal-title":"JACC Cardiovasc Interv"},{"key":"2026100816021984000_oeag155-B5","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1161\/CIRCULATIONAHA.124.071139","article-title":"Prevalence and clinical outcomes of discordant lesions between fractional flow reserve and nonhyperemic pressure ratios in clinical practice: the J-PRIDE registry","volume":"151","author":"Kuramitsu","year":"2025","journal-title":"Circulation"},{"key":"2026100816021984000_oeag155-B6","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1080\/14779072.2025.2603971","article-title":"How coronary plaque morphology affects fractional flow reserve: clinical evidence from intravascular imaging studies","volume":"24","author":"Murai","year":"2026","journal-title":"Expert Rev Cardiovasc Ther"},{"key":"2026100816021984000_oeag155-B7","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1093\/eurheartj\/ehv690","article-title":"Coronary plaque quantification and fractional flow reserve by coronary computed tomography angiography identify ischaemia-causing lesions","volume":"37","author":"Gaur","year":"2016","journal-title":"Eur Heart J"},{"key":"2026100816021984000_oeag155-B8","doi-asserted-by":"crossref","first-page":"117530","DOI":"10.1016\/j.atherosclerosis.2024.117530","article-title":"Evaluation of fractional flow reserve and atherosclerotic plaque characteristics on coronary non-contrast T1-weighted magnetic resonance imaging","volume":"392","author":"Sugane","year":"2024","journal-title":"Atherosclerosis"},{"key":"2026100816021984000_oeag155-B9","doi-asserted-by":"crossref","first-page":"2058","DOI":"10.1016\/j.jcin.2018.07.012","article-title":"Optical coherence tomography-defined plaque vulnerability in relation to functional stenosis severity and microvascular dysfunction","volume":"11","author":"Usui","year":"2018","journal-title":"JACC Cardiovasc Interv"},{"key":"2026100816021984000_oeag155-B10","doi-asserted-by":"crossref","first-page":"362","DOI":"10.21037\/cdt-20-1024","article-title":"The association between the extent of lipidic burden and delta-fractional flow reserve: analysis from coronary physiological and near-infrared spectroscopic measures","volume":"11","author":"Murai","year":"2021","journal-title":"Cardiovasc Diagn Ther"},{"key":"2026100816021984000_oeag155-B11","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/s12928-020-00653-7","article-title":"Clinical expert consensus document on quantitative coronary angiography from the Japanese association of cardiovascular intervention and therapeutics","volume":"35","author":"Suzuki","year":"2020","journal-title":"Cardiovasc Interv Ther"},{"key":"2026100816021984000_oeag155-B12","doi-asserted-by":"crossref","first-page":"2003","DOI":"10.1161\/hc4201.099223","article-title":"Coronary thermodilution to assess flow reserve: experimental validation","volume":"104","author":"De Bruyne","year":"2001","journal-title":"Circulation"},{"key":"2026100816021984000_oeag155-B13","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1038\/s41569-020-0374-z","article-title":"Non-hyperaemic coronary pressure measurements to guide coronary interventions","volume":"17","author":"van De Hoef","year":"2020","journal-title":"Nat Rev Cardiol"},{"key":"2026100816021984000_oeag155-B14","doi-asserted-by":"crossref","first-page":"2055","DOI":"10.1093\/eurheartj\/eht040","article-title":"Safety and efficacy of a novel hyperaemic agent, intracoronary nicorandil, for invasive physiological assessments in the cardiac catheterization laboratory","volume":"34","author":"Jang","year":"2013","journal-title":"Eur Heart J"},{"key":"2026100816021984000_oeag155-B15","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCINTERVENTIONS.124.013830","article-title":"Change in Pd\/Pa: clinical implications for predicting future cardiac events at deferred coronary lesions","volume":"17","author":"Murai","year":"2024","journal-title":"Circ Cardiovasc Interv"},{"key":"2026100816021984000_oeag155-B16","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1080\/14779072.2017.1367287","article-title":"In vivo visualization of lipid coronary atheroma with intravascular near-infrared spectroscopy","volume":"15","author":"Kataoka","year":"2017","journal-title":"Expert Rev Cardiovasc Ther"},{"key":"2026100816021984000_oeag155-B17","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1016\/j.jcmg.2008.06.001","article-title":"Detection of lipid core coronary plaques in autopsy specimens with a novel catheter-based near-infrared spectroscopy system","volume":"1","author":"Gardner","year":"2008","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026100816021984000_oeag155-B18","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1016\/S0140-6736(19)31794-5","article-title":"Identification of patients and plaques vulnerable to future coronary events with near-infrared spectroscopy intravascular ultrasound imaging: a prospective, cohort study","volume":"394","author":"Waksman","year":"2019","journal-title":"Lancet"},{"key":"2026100816021984000_oeag155-B19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s12928-023-00957-4","article-title":"CVIT 2023 clinical expert consensus document on intravascular ultrasound","volume":"39","author":"Saito","year":"2024","journal-title":"Cardiovasc Interv Ther"},{"key":"2026100816021984000_oeag155-B20","doi-asserted-by":"crossref","first-page":"2223","DOI":"10.1056\/NEJMoa1610227","article-title":"Everolimus-eluting stents or bypass surgery for left main coronary artery disease","volume":"375","author":"Stone","year":"2016","journal-title":"N Engl J Med"},{"key":"2026100816021984000_oeag155-B21","doi-asserted-by":"crossref","first-page":"2231","DOI":"10.1016\/j.jacc.2018.08.1038","article-title":"Fourth universal definition of myocardial infarction (2018)","volume":"72","author":"Thygesen","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2026100816021984000_oeag155-B22","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1056\/NEJMoa1907775","article-title":"Complete revascularization with multivessel PCI for myocardial infarction","volume":"381","author":"Mehta","year":"2019","journal-title":"N Engl J Med"},{"key":"2026100816021984000_oeag155-B23","doi-asserted-by":"crossref","first-page":"S42","DOI":"10.1016\/j.jcmg.2012.01.008","article-title":"Plaque composition and clinical outcomes in acute coronary syndrome patients with metabolic syndrome or diabetes","volume":"5","author":"Marso","year":"2012","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026100816021984000_oeag155-B24","doi-asserted-by":"crossref","first-page":"1452","DOI":"10.1016\/j.jcmg.2023.05.018","article-title":"Coronary atherosclerosis phenotypes in focal and diffuse disease","volume":"16","author":"Sakai","year":"2023","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026100816021984000_oeag155-B25","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/j.jacl.2024.12.019","article-title":"Characterization of lipidic plaque features in association with LDL-C &lt; 70\u2005mg\/dL and lipoprotein(a) &lt; 50\u2005mg\/dL","volume":"19","author":"Shishikura","year":"2025","journal-title":"J Clin Lipidol"},{"key":"2026100816021984000_oeag155-B26","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.jcmg.2011.09.025","article-title":"Distance of lipid core-rich plaques from the ostium by NIRS in nonculprit coronary arteries","volume":"5","author":"Brugaletta","year":"2012","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026100816021984000_oeag155-B27","unstructured":"Hartig \u00a0F\n          . DHARMa: residual diagnostics for hierarchical (multi-level\/mixed) regression models. R package version 0.5.0. 2026."},{"key":"2026100816021984000_oeag155-B28","unstructured":"R Core Team\n          . R: a language and environment for statistical computing. R Foundation for Statistical Computing. 2014."},{"key":"2026100816021984000_oeag155-B29","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1161\/01.ATV.0000051384.43104.FC","article-title":"Endothelial dysfunction: a marker of atherosclerotic risk","volume":"23","author":"Bonetti","year":"2003","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"2026100816021984000_oeag155-B30","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1136\/hrt.2009.166017","article-title":"Segmental coronary endothelial dysfunction in patients with minimal atherosclerosis is associated with necrotic core plaques","volume":"95","author":"Lavi","year":"2009","journal-title":"Heart"},{"key":"2026100816021984000_oeag155-B31","doi-asserted-by":"crossref","first-page":"2047","DOI":"10.1093\/eurheartj\/eht132","article-title":"Coronary endothelial dysfunction in patients with early coronary artery disease is associated with the increase in intravascular lipid core plaque","volume":"34","author":"Choi","year":"2013","journal-title":"Eur Heart J"},{"key":"2026100816021984000_oeag155-B32","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1007\/s10554-014-0545-2","article-title":"Coronary atheroma composition and its association with segmental endothelial dysfunction in non-ST segment elevation myocardial infarction: novel insights with radiofrequency (iMAP) intravascular ultrasonography","volume":"31","author":"Puri","year":"2015","journal-title":"Int J Cardiovasc Imaging"},{"key":"2026100816021984000_oeag155-B33","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1093\/oxfordjournals.eurheartj.a015305","article-title":"Mechanisms of adenosine-induced epicardial coronary artery dilatation","volume":"18","author":"Lupi","year":"1997","journal-title":"Eur Heart J"},{"key":"2026100816021984000_oeag155-B34","doi-asserted-by":"crossref","first-page":"16005","DOI":"10.1038\/s41598-023-43352-y","article-title":"Differential predictability for high-risk plaque characteristics between fractional flow reserve and instantaneous wave-free ratio","volume":"13","author":"Lee","year":"2023","journal-title":"Sci Rep"},{"key":"2026100816021984000_oeag155-B35","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.jcmg.2024.07.021","article-title":"Predictors for vulnerable plaque in functionally significant lesions","volume":"18","author":"Yang","year":"2025","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026100816021984000_oeag155-B36","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1161\/hc0802.104291","article-title":"Detection of lipid pool, thin fibrous cap, and inflammatory cells in human aortic atherosclerotic plaques by near-infrared spectroscopy","volume":"105","author":"Moreno","year":"2002","journal-title":"Circulation"},{"key":"2026100816021984000_oeag155-B37","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCINTERVENTIONS.118.007494","article-title":"Physiological pattern of disease assessed by pressure-wire pullback has an influence on fractional flow reserve\/instantaneous wave-free ratio discordance","volume":"12","author":"Warisawa","year":"2019","journal-title":"Circ Cardiovasc Interv"},{"key":"2026100816021984000_oeag155-B38","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1016\/j.jcin.2024.12.017","article-title":"Physiological disease pattern as assessed by pull back pressure gradient Index in vessels with FFR\/iFR discordance","volume":"18","author":"Revaiah","year":"2025","journal-title":"JACC Cardiovasc Interv"},{"key":"2026100816021984000_oeag155-B39","doi-asserted-by":"crossref","first-page":"2379","DOI":"10.1016\/j.jacc.2007.02.059","article-title":"Role of endothelial shear stress in the natural history of coronary atherosclerosis and vascular remodeling: molecular, cellular, and vascular behavior","volume":"49","author":"Chatzizisis","year":"2007","journal-title":"J Am Coll Cardiol"},{"key":"2026100816021984000_oeag155-B40","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.atherosclerosis.2018.04.022","article-title":"The relationship between segmental wall shear stress and lipid core plaque derived from near-infrared spectroscopy","volume":"275","author":"Shishikura","year":"2018","journal-title":"Atherosclerosis"},{"key":"2026100816021984000_oeag155-B41","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1016\/S0140-6736(21)00249-X","article-title":"Identification of vulnerable plaques and patients by intracoronary near-infrared spectroscopy and ultrasound (PROSPECT II): a prospective natural history study","volume":"397","author":"Erlinge","year":"2021","journal-title":"Lancet"},{"key":"2026100816021984000_oeag155-B42","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1016\/S0140-6736(24)00413-6","article-title":"Preventive percutaneous coronary intervention versus optimal medical therapy alone for the treatment of vulnerable atherosclerotic coronary plaques (PREVENT): a multicentre, open-label, randomised controlled trial","volume":"403","author":"Park","year":"2024","journal-title":"Lancet"},{"key":"2026100816021984000_oeag155-B43","doi-asserted-by":"crossref","first-page":"1907","DOI":"10.1016\/j.jcin.2020.05.040","article-title":"Influence of anatomical and clinical characteristics on long-term prognosis of FFR-guided deferred coronary lesions","volume":"13","author":"Cho","year":"2020","journal-title":"JACC Cardiovasc Interv"},{"key":"2026100816021984000_oeag155-B44","doi-asserted-by":"crossref","first-page":"e011387","DOI":"10.1161\/CIRCINTERVENTIONS.121.011387","article-title":"Five-year outcomes after fractional flow reserve-based deferral of revascularization in chronic coronary syndrome: final results from the J-CONFIRM registry","volume":"15","author":"Kuramitsu","year":"2022","journal-title":"Circ Cardiovasc Interv"},{"key":"2026100816021984000_oeag155-B45","doi-asserted-by":"crossref","first-page":"4671","DOI":"10.1093\/eurheartj\/ehab433","article-title":"Thin-cap fibroatheroma predicts clinical events in diabetic patients with normal fractional flow reserve: the COMBINE OCT-FFR trial","volume":"42","author":"Kedhi","year":"2021","journal-title":"Eur Heart J"},{"key":"2026100816021984000_oeag155-B46","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.4244\/EIJ-D-22-00562","article-title":"Outcomes of non-ischaemic coronary lesions with high-risk plaque characteristics on coronary CT angiography","volume":"18","author":"Yang","year":"2023","journal-title":"EuroIntervention"}],"container-title":["European Heart Journal Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjopen\/advance-article-pdf\/doi\/10.1093\/ehjopen\/oeag155\/71226245\/oeag155.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjopen\/article-pdf\/6\/5\/oeag155\/71226245\/oeag155.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjopen\/article-pdf\/6\/5\/oeag155\/71226245\/oeag155.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:02:33Z","timestamp":1791489753000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjopen\/article\/doi\/10.1093\/ehjopen\/oeag155\/8817312"}},"subtitle":[],"editor":[{"given":"Salvatore","family":"De Rosa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":46,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,9,2]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjopen\/oeag155","relation":{},"ISSN":["2752-4191"],"issn-type":[{"value":"2752-4191","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,9]]},"published":{"date-parts":[[2026,9]]},"article-number":"oeag155"}}