PMID- 30997122
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20210203
LR  - 20231006
IS  - 2053-3624 (Print)
IS  - 2053-3624 (Electronic)
IS  - 2053-3624 (Linking)
VI  - 6
IP  - 1
DP  - 2019
TI  - Intracoronary near-infrared spectroscopy and the risk of future cardiovascular 
      events.
PG  - e000917
LID - 10.1136/openhrt-2018-000917 [doi]
LID - e000917
AB  - OBJECTIVES: The objectives of this study were to investigate if findings by 
      intracoronary near-infrared spectroscopy (NIRS) and intravascular ultrasound 
      (IVUS) are associated with future cardiovascular events and if NIRS can 
      differentiate culprit from non-culprit segments in patients with coronary artery 
      disease. METHODS: The study included 144 patients with coronary artery disease 
      undergoing percutaneous coronary intervention and combined NIRS-IVUS imaging at 
      two Swedish hospitals. The NIRS-derived lipid core burden index (LCBI), the 4 mm 
      segment with maximum LCBI (MaxLCBI(4mm)) and the IVUS-derived maximum plaque 
      burden (MaxPB) were analysed within the culprit segment and continuous 10 mm 
      non-culprit segments of the index culprit vessels. The association with future 
      major adverse cardiovascular and cerebrovascular events (MACCE), defined as 
      all-cause mortality, acute coronary syndrome requiring revascularisation and 
      cerebrovascular events during follow-up was evaluated using multivariable Cox 
      regressions. A receiver operating characteristic (ROC) analysis was performed to 
      test the ability of NIRS to discriminate culprit against non-culprit segments. 
      RESULTS: A non-culprit maxLCBI(4mm) >/=400 (HR: 3.67, 95% CI 1.46 to 9.23, p=0.006) 
      and a non-culprit LCBI >/= median (HR: 3.08, 95% CI 1.11 to 8.56, p=0.031) were 
      both significantly associated with MACCE, whereas a non-culprit MaxPB >/=70% (HR: 
      0.61, 95% CI 0.08 to 4.59, p=0.63) was not. The culprit segments had larger lipid 
      cores compared with non-culprit segments (MaxLCBI(4mm) 425 vs 74, p<0.001), and 
      the ROC analysis showed that NIRS can differentiate culprit against non-culprit 
      segments (c-statistics: 0.85, 95% CI 0.81 to 0.89). CONCLUSION: A maxLCBI(4mm) 
      >/=400 and LCBI >/= median, assessed by NIRS in non-culprit segments of a culprit 
      artery, were significantly associated with patient-level MACCE. NIRS furthermore 
      adequately discriminated culprit against non-culprit segments in patients with 
      coronary disease.
FAU - Karlsson, Sofia
AU  - Karlsson S
AD  - Department of Cardiology, Clinical Sciences, Lund University, Skane University 
      Hospital, Lund, Sweden.
FAU - Anesater, Erik
AU  - Anesater E
AD  - Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska 
      Institutet, Danderyd Hospital, Stockholm, Sweden.
FAU - Fransson, Klara
AU  - Fransson K
AD  - Department of Cardiology, Clinical Sciences, Lund University, Skane University 
      Hospital, Lund, Sweden.
FAU - Andell, Pontus
AU  - Andell P
AD  - Department of Cardiology, Clinical Sciences, Lund University, Skane University 
      Hospital, Lund, Sweden.
FAU - Persson, Jonas
AU  - Persson J
AD  - Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska 
      Institutet, Danderyd Hospital, Stockholm, Sweden.
FAU - Erlinge, David
AU  - Erlinge D
AD  - Department of Cardiology, Clinical Sciences, Lund University, Skane University 
      Hospital, Lund, Sweden.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190209
PL  - England
TA  - Open Heart
JT  - Open heart
JID - 101631219
PMC - PMC6443121
OTO - NOTNLM
OT  - intravascular ultrasound
OT  - lipid-rich plaques
OT  - near-infrared spectroscopy
OT  - vulnerable plaques
COIS- Competing interests: None declared.
EDAT- 2019/04/19 06:00
MHDA- 2019/04/19 06:01
PMCR- 2019/02/09
CRDT- 2019/04/19 06:00
PHST- 2018/08/23 00:00 [received]
PHST- 2018/10/04 00:00 [revised]
PHST- 2018/10/04 00:00 [accepted]
PHST- 2019/04/19 06:00 [entrez]
PHST- 2019/04/19 06:00 [pubmed]
PHST- 2019/04/19 06:01 [medline]
PHST- 2019/02/09 00:00 [pmc-release]
AID - openhrt-2018-000917 [pii]
AID - 10.1136/openhrt-2018-000917 [doi]
PST - epublish
SO  - Open Heart. 2019 Feb 9;6(1):e000917. doi: 10.1136/openhrt-2018-000917. 
      eCollection 2019.