🔍 LCR ≥0.33 → 4.3x higher 5year event risk

New data from the COMBINE OCTFFR trial (Elvin Kedhi, McGill University) show that an AIpowered OCT vulnerability index – the LipidtoCap Ratio (LCR) – can identify diabetic patients with nonflowlimiting lesions (FFR >0.80) who remain at substantially higher longterm risk.

📌 Study – 419 lesions, 357 diabetic patients
📌 Key cutoff – LCR ≥0.33
📌 5year lesionoriented composite endpoint (LOCE) – HR 4.30 (95% CI 2.17–8.51, p<0.001)
📌 Continuous LCR – 2.86fold risk increase per tertile

💡 Clinical insight
Vulnerable plaques can cause events even without ischemia. Traditional OCT analysis is timeconsuming and readerdependent. AIpowered LCR provides standardised, automated, realtime risk stratification – enabling more precise, lesionlevel decisions in the cath lab.

🎯 Key implication
In diabetic patients, AIderived LCR from OCT unmasks vulnerable plaques with a >4fold higher risk of future adverse events, supporting a proactive rather than deferral strategy.

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