• Eur Heart J Cardiovasc Imaging · Apr 2016

    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, 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, and James E Muller.
    • Frederik Meijer Heart and Vascular Institute, Spectrum Health, 100 Michigan Street NE, Grand Rapids, MI 49503, USA ryan.madder@spectrumhealth.org.
    • Eur Heart J Cardiovasc Imaging. 2016 Apr 1; 17 (4): 393-9.

    AimsA 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 ResultsThis 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).ConclusionDetection 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.Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

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