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Near-infrared spectroscopy predicted CV outcomes in patients with CAD
Patients with CAD who had lipid core burden index rates of at least the median, as assessed by near-infrared spectroscopy, had a fourfold increased risk for CV events at 1 year, according to results from the ATHEROREMO-NIRS substudy.
Researchers studied the long-term prognostic value of near-infrared spectroscopy in 203 patients with CAD. According to the study background, near-infrared spectroscopy can identify lipid core-containing plaques, which can then be quantified as a lipid core burden index.
The researchers performed intravascular near-infrared spectroscopy (TVC Imaging System, Infraredx) in a nonculprit coronary artery of patients referred for angiography because of stable angina pectoris or ACS.
Rohit M. Oemrawsingh, MD, MSc, and colleagues reported that the primary endpoint, a composite of all-cause mortality, nonfatal ACS, stroke and unplanned coronary revascularization, had occurred in 10.4% of patients at 1 year. In patients with a lipid core burden index of at least the median of 43, the rate of the primary outcome at 1 year was 16.7% compared with 4% for patients with a lipid core burden index less than 43 (adjusted HR=4.04; 95% CI, 1.33-12.29). The relationship between lipid core burden index and the primary endpoint was similar between patients with stable angina pectoris and those with ACS (P for heterogeneity=.14).
The researchers also reported a similar relationship between patients with lipid core burden index ≥43 vs. <43 and the prespecified secondary endpoints of all-cause mortality or nonfatal ACS (8.8% vs. 1%; P=.01); all-cause mortality, stroke or nonfatal ACS (11.8% vs. 1%; P=.002); and all-cause mortality, nonfatal ACS or unplanned PCI (13.7% vs. 4%; P=.014).
“Our findings suggest that the use of [near-infrared spectroscopy] imaging to identify and quantify lipid-core plaque in the nonculprit arteries, which would otherwise remain undetected by coronary angiography, could be a viable tool to assess the vascular vulnerability of the larger coronary tree,” Oemrawsingh, from the Thoraxcenter, department of cardiology, Erasmus Medical Center and Cardiovascular Research Institute COEUR, Rotterdam, the Netherlands, said in a press release. “The findings of our investigator-initiated, prospective study seem promising, but external validation, preferably in a larger sample size, is a fundamental prerequisite before any of our conclusions might be considered for possible future clinical implications.”
Disclosure: The study was funded by the European Commission and the Seventh Framework Program. The researchers report financial ties with Medtronic, the Netherlands Heart Foundation, Sanofi and Servier.