Intracoronary near-infrared spectroscopy and the risk of future cardiovascular events

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title = "Intracoronary near-infrared spectroscopy and the risk of future cardiovascular events",
abstract = "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.",
keywords = "intravascular ultrasound, lipid-rich plaques, near-infrared spectroscopy, vulnerable plaques",
author = "Sofia Karlsson and Erik Anes{\"a}ter and Klara Fransson and Pontus Andell and Jonas Persson and David Erlinge",
year = "2019",
doi = "10.1136/openhrt-2018-000917",
language = "English",
volume = "6",
journal = "Open Heart",
issn = "2053-3624",
publisher = "BMJ Publishing Group",
number = "1",