Abstract 14764: Segmental Analysis of Near-Infrared Spectroscopy and Cardiovascular Outcome in Patients With Coronary Artery Disease
Introduction: Recently it has been demonstrated that the lipid core burden index (LCBI), as assessed by intracoronary near-infrared spectroscopy (NIRS) in a non-culprit coronary artery, is predictive for MACE during 1-year follow-up. Currently, no data are available on the prognostic value of the worst 10 and 4 mm segments with the highest LCBI.
Methods: In this prospective, observational study, NIRS imaging was performed in a non-culprit coronary artery in 203 CAD patients referred for coronary angiography. The LCBI was determined off-line for the entire segment (median pullback length 63.1 mm) and the 10 and 4 mm segments with the highest LCBI (maxLCBI10mm and maxLCBI4mm) in a blinded core laboratory. The primary endpoint was MACE within one year follow-up, defined as the composite of all-cause mortality, non-fatal ACS, stroke and unplanned coronary revascularization. The secondary endpoint was the composite of all-cause mortality and non-fatal ACS.
Results: The 1-year cumulative incidence of MACE was 10.4%.The median LCBI value for the entire segment was 43. MACE was observed in 16.7% of patients with a LCBI > median vs 4.0% in those with a LCBI < median (adjusted HR: 4.0; 95%CI: 1.3-12, p=0.014). Median LCBIs in the maxLCBI10mm and maxLCBI4mm were 132 and 234, respectively. Patients with maxLCBI10mm > median (14.7 vs 5.9%, P=0.11) and maxLCBI4mm > median (13.9 vs 6.9%, P=0.22) had higher incidence of MACE than those < median, but statistical significance was not reached. We found significant associations with the secondary endpoint of all-cause mortality and non-fatal ACS (figure 1).
Conclusion: LCBI above the median, as assessed by NIRS imaging of an entire segment in a non-culprit coronary artery is associated with MACE during one-year follow-up. The predictive value of the LCBI of the worst 10 and 4 mm segments in a non-culprit coronary artery is less robust.
- © 2013 by American Heart Association, Inc.