Multimodality imaging to identify lipid-rich coronary plaques and predict periprocedural myocardial injury: Association between near-infrared spectroscopy and coronary computed tomography angiography

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Takashi Muramatsu¹  Hiroshi Takahashi¹  Hideki Kawai¹  Hideo Izawa¹  Takeshi Kondo²  Munenori Okubo²  Masanori Kawasaki²  Yoshiaki Kawase²  Hitoshi Matsuo²  Yoshihiro Sobue³  Hideaki Ota⁴  Yuki Nakashima⁵  Shunsuke Imai⁵ 

[1] Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan;Department of Cardiology, Gifu Heart Center, Gifu, Japan;Department of Cardiology, Gifu Heart Center, Gifu, Japan;Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Japan;Department of Cardiology, Gifu Heart Center, Gifu, Japan;Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan;Department of Radiology, Gifu Heart Center, Gifu, Japan;

关键词: near-infrared spectroscopy;    coronary computed tomography angiography;    lipid-rich plaque;    percutaneous coronary intervention;    periprocedural myocardial injury (PMI);   

DOI  :  10.3389/fcvm.2023.1127121

 received in 2022-12-19, accepted in 2023-03-09,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundThis study compares the efficacy of coronary computed tomography angiography (CCTA) and near-infrared spectroscopy intravascular ultrasound (NIRS–IVUS) in patients with significant coronary stenosis for predicting periprocedural myocardial injury during percutaneous coronary intervention (PCI).MethodsWe prospectively enrolled 107 patients who underwent CCTA before PCI and performed NIRS–IVUS during PCI. Based on the maximal lipid core burden index for any 4-mm longitudinal segments (maxLCBI4mm) in the culprit lesion, we divided the patients into two groups: lipid-rich plaque (LRP) group (maxLCBI4mm ≥ 400; n = 48) and no-LRP group (maxLCBI4mm < 400; n = 59). Periprocedural myocardial injury was a postprocedural cardiac troponin T (cTnT) elevation of ≥5 times the upper limit of normal.ResultsThe LRP group had a significantly higher cTnT (p = 0.026), lower CT density (p < 0.001), larger percentage atheroma volume (PAV) by NIRS–IVUS (p = 0.036), and larger remodeling index measured by both CCTA (p = 0.020) and NIRS–IVUS (p < 0.001). A significant negative linear correlation was found between maxLCBI4mm and CT density (rho = −0.552, p < 0.001). Multivariable logistic regression analysis identified maxLCBI4mm [odds ratio (OR): 1.006, p = 0.003] and PAV (OR: 1.125, p = 0.014) as independent predictors of periprocedural myocardial injury, while CT density was not an independent predictor (OR: 0.991, p = 0.22).ConclusionCCTA and NIRS–IVUS correlated well to identify LRP in culprit lesions. However, NIRS–IVUS was more competent in predicting the risk of periprocedural myocardial injury.

【 授权许可】

Unknown   
© 2023 Ota, Matsuo, Imai, Nakashima, Kawase, Okubo, Takahashi, Kawai, Sobue, Kawasaki, Kondo, Muramatsu and Izawa.