Large lipid-rich coronary plaques detected by near-infrared spectroscopy at non-stented sites in the target artery identify patients likely to experience future major adverse cardiovascular events - PubMed
Observational Study
doi: 10.1093/ehjci/jev340. Epub 2016 Jan 22.
Mustafa Husaini 2 , Alan T Davis 3 , Stacie VanOosterhout 2 , Mohsin Khan 2 , David Wohns 2 , Richard F McNamara 2 , Kevin Wolschleger 2 , John Gribar 2 , J Stewart Collins 2 , Mark Jacoby 2 , Jeffrey M Decker 2 , Michael Hendricks 4 , Stephen T Sum 4 , Sean Madden 4 , James H Ware 5 , James E Muller 4
Affiliations
- PMID: 26800770
- DOI: 10.1093/ehjci/jev340
Observational Study
Large lipid-rich coronary plaques detected by near-infrared spectroscopy at non-stented sites in the target artery identify patients likely to experience future major adverse cardiovascular events
Ryan D Madder et al. Eur Heart J Cardiovasc Imaging. 2016 Apr.
Abstract
Aims: A recent study demonstrated that intracoronary near-infrared spectroscopy (NIRS) findings in non-target vessels are associated with major adverse cardiovascular and cerebrovascular events (MACCE). It is unknown whether NIRS findings at non-stented sites in target vessels are similarly associated with future MACCE. This study evaluated the association between large lipid-rich plaques (LRP) detected by NIRS at non-stented sites in a target artery and subsequent MACCE.
Methods and results: This study evaluated 121 consecutive registry patients undergoing NIRS imaging in a target artery. After excluding stented segments, target arteries were evaluated for a large LRP, defined as a maximum lipid core burden index in 4 mm (maxLCBI4 mm) ≥400. Excluding events in stented segments, Cox regression analysis was performed to evaluate for an association between a maxLCBI4 mm ≥400 and future MACCE, defined as all-cause mortality, non-fatal acute coronary syndrome, and cerebrovascular events. NIRS detected a maxLCBI4 mm ≥400 in a non-stented segment of the target artery in 17.4% of patients. The only baseline clinical variable marginally associated with MACCE was ejection fraction (HR 0.96, 95% CI 0.93-1.00, P = 0.054). A maxLCBI4 mm ≥400 in a non-stented segment at baseline was significantly associated with MACCE during follow-up (HR 10.2, 95% CI 3.4-30.6, P < 0.001).
Conclusion: Detection of large LRP by NIRS at non-stented sites in a target artery was associated with an increased risk of future MACCE. These findings support ongoing prospective studies to further evaluate the ability of NIRS to identify vulnerable patients.
Keywords: lipid-rich plaque; near-infrared spectroscopy; vulnerable patient.
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.
Comment in
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Pancoronary instability: the vulnerable patient revisited?
Mintz GS. Mintz GS. Eur Heart J Cardiovasc Imaging. 2016 Apr;17(4):400-1. doi: 10.1093/ehjci/jew016. Epub 2016 Feb 18. Eur Heart J Cardiovasc Imaging. 2016. PMID: 26896415 No abstract available.
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Maehara A, Stone GW. Maehara A, et al. Circ Cardiovasc Imaging. 2017 Oct;10(10):e007116. doi: 10.1161/CIRCIMAGING.117.007116. Circ Cardiovasc Imaging. 2017. PMID: 28982648 No abstract available.
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