Long-term follow-up after near-infrared spectroscopy coronary imaging: Insights from the lipid cORe plaque association with CLinical events (ORACLE-NIRS) registry

Autor: Aris Karatasakis, Subhash Banerjee, Michele Roesle, Pratik Kalsaria, Shuaib M Abdullah, Erica Resendes, Judit Karacsonyi, Phuong Khanh J Nguyen-Trong, Aya Alame, Bavana V. Rangan, Emmanouil S. Brilakis, Barbara A. Danek
Rok vydání: 2017
Předmět:
Male
medicine.medical_specialty
Acute coronary syndrome
Time Factors
medicine.medical_treatment
Coronary Artery Disease
Kaplan-Meier Estimate
030204 cardiovascular system & hematology
Coronary Angiography
Coronary artery disease
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Risk Factors
Interquartile range
Internal medicine
Myocardial Revascularization
medicine
Humans
Cumulative incidence
Registries
030212 general & internal medicine
Acute Coronary Syndrome
Stroke
Aged
Proportional Hazards Models
Retrospective Studies
Chi-Square Distribution
Spectroscopy
Near-Infrared
business.industry
Hazard ratio
Percutaneous coronary intervention
General Medicine
Middle Aged
Prognosis
medicine.disease
Coronary Vessels
Lipids
Plaque
Atherosclerotic
Cardiac Imaging Techniques
Multivariate Analysis
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Mace
Follow-Up Studies
Zdroj: Cardiovascular Revascularization Medicine. 18:177-181
ISSN: 1553-8389
Popis: Background Coronary lipid core plaque may be associated with the incidence of subsequent cardiovascular events. Methods We analyzed outcomes of 239 patients who underwent near-infrared spectroscopy (NIRS) coronary imaging between 2009–2011. Multivariable Cox regression was used to identify variables independently associated with the incidence of major adverse cardiovascular events (MACE; cardiac mortality, acute coronary syndromes (ACS), stroke, and unplanned revascularization) during follow-up. Results Mean patient age was 64 ± 9 years, 99% were men, and 50% were diabetic, presenting with stable coronary artery disease (61%) or an acute coronary syndrome (ACS, 39%). Target vessel pre-stenting median lipid core burden index (LCBI) was 88 [interquartile range, IQR 50–130]. Median LCBI in non-target vessels was 57 [IQR 26–94]. Median follow-up was 5.3 years. The 5-year MACE rate was 37.5% (cardiac mortality was 15.0%). On multivariable analysis the following variables were associated with MACE: diabetes mellitus, prior percutaneous coronary intervention performed at index angiography, and non-target vessel LCBI. Non-target vessel LCBI of 77 was determined using receiver-operating characteristic curve analysis to be a threshold for prediction of MACE in our cohort. The adjusted hazard ratio (HR) for non-target vessel LCBI ≥77 was 14.05 (95% confidence interval (CI) 2.47–133.51, p = 0.002). The 5-year cumulative incidence of events in the above-threshold group was 58.0% vs. 13.1% in the below-threshold group. Conclusion During long-term follow-up of patients who underwent NIRS imaging, high LCBI in a non-PCI target vessel was associated with increased incidence of MACE.
Databáze: OpenAIRE
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