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, Mustafa Husaini, Alan T. Davis, Stacie Vanoosterhout, Mohsin Khan, David Wohns, Richard F. Mcnamara, Kevin Wolschleger, John Gribar, J. Stewart Collins, Mark Jacoby, Jeffrey M. Decker, Michael Hendricks, Stephen T. Sum, Sean Madden, James H. Ware, James E. Muller

Research output: Contribution to journalArticlepeer-review

33 Scopus citations

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 (maxLCBI4mm) ≥400. Excluding events in stented segments, Cox regression analysis was performed to evaluate for an association between a maxLCBI4mm ≥400 and future MACCE, defined as all-cause mortality, non-fatal acute coronary syndrome, and cerebrovascular events. NIRS detected a maxLCBI4mm ≥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 maxLCBI4mm ≥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.

Original languageEnglish
Pages (from-to)393-399
Number of pages7
JournalEuropean heart journal cardiovascular Imaging
Volume17
Issue number4
DOIs
StatePublished - Apr 1 2016
Externally publishedYes

Keywords

  • lipid-rich plaque
  • near-infrared spectroscopy
  • vulnerable patient

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