Assessment of coronary necrotic core burden using a near-infrared spectroscopy imaging to predict cardiovascular events in Asian patients with coronary artery disease

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Abstract

Background and Aims

This study was designed to address the question whether a combined near-infrared spectroscopy(NIRS) – intravascular ultrasound(IVUS) imaging predicts cardiovascular outcomes in Asian patients with coronary artery disease(CAD).

Methods

The Ajou NIRS registry enrolled 597 patients who underwent coronary angiography with NIRS-IVUS imaging analysis for ischemic heart diseases from Jan, 2015 to Aug, 2019 in an Asian single center. Residual maximum lipid core burden index in 4 mm segment (maxLCBI_4mm) from non-treated lesions after PCI. The major adverse cardiovascular events(MACE) was defines as the composite all cause death, non-fetal MI, stroke or revascularization during follow-up.

Results

398 patients were assessed for this study after excluding patients who had non-analyzable vessels or clinical follow up less than 1 year. The median value of residual maxLCBI_4mm was 112[0, 289.0]. Average mean follow-up period was 1064.5±382.7 days. 32 patients(8%) had non-stent related events (2 all cause death, 5 non-fetal MI, 1 stroke and 31 revascularization). There were no differences of clinical parameters including lipid profiles between the patients with MACE and without. Patients with MACE had higher value of residual maxLCBI_4mm compared with those without(301.5 vs 94, p=0.003). By ROC curve analysis, the value of maxLCBI_4mm was 260.5 as a predictor for MACE(AUC 0.697, sensitivity 70.0 %, and specificity 73.5%).

Conclusions

Residual lipid core burden assessed by using NIRS-IVUS imaging in non-stented coronary arteries can be used as a predictor to identify patients at high risk for future cardiovascular events in Asian population. Ethnic difference in the absolute value of maxLCBI_4mm should be verified in larger studies.

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