Comparison of two different methods of quantitative coronary angiography in patients with acute coronary syndromes

The minimal cost algorithm (MCA) commonly used for quantitative coronary arteriography has limitations in definition of complex lesion morphology. A gradient field transform (GFT) algorithm has been designed for the better analysis of complex lesions. We compared MCA with GFT in angiograms of 125 patients in the Myocardial Infarction with Novastan and t-PA (MINT) trial. Lesion border definition was rated as one (poor), two (good), or three (very good). While MCA- and GFT-derived reference diameters (RDs) were similar, GFT yielded smaller minimal lumen diameter (MLD) than MCA by 0.22 +/- 0.31 mm (P < 0.01), and the difference between GFT- and MCA-derived MLDs increased with decreasing MLD. Mean percent diameter stenosis (% DS) was 9.1% +/- 11.1% greater by GFT (P < 0.001). Lesion border definition in simple lesions was similar (not significantly different). However, in complex lesions GFT performed better (2.49 +/- 0.61 vs. 2.11 +/- 0.74; P < 0.05). Thus, GFT appears to improve analysis of complex lesions compared to MCA. GFTs role in angiographic trials and clinical practice deserves further study. (C) 2002 Wiley-Liss, Inc.