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Near-Infrared Spectroscopy Identifies Lesions with Increased Likelihood of MI after PCI
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Plaque characterization using near-infrared spectroscopy identified lipid-rich lesions that conferred increased risk for periprocedural MI after stent implantation, according to results of the CANARY trial.
However, while researchers attributed the MI risk to distal embolization, use of a distal protection filter did not prevent the myonecrosis of lipid-rich plaques after PCI.
The CANARY trial included 85 patients at 9 U.S. centers undergoing implantation of a stent in a single coronary lesion. Each patient also underwent near-infrared spectroscopy and IVUS at baseline. Lesions with a maximal lipid core burden index ≥ 600 for any 4-mm length were randomized to PCI with or without a distal protection filter.
Gregg W. Stone
Median maximal lipid core burden index was 448.4 before PCI and 156 after PCI (P < .0001), Gregg W. Stone, MD, from Columbia University Medical Center, New York-Presbyterian Hospital and the Cardiovascular Research Foundation, and colleagues reported.
The primary endpoint was periprocedural MI, which developed in 24.7% of patients. Maximal lipid core burden index was higher in patients with periprocedural MI vs. no periprocedural MI (481.5 vs. 371.5; P = .05).
Thirty-one lesions met the maximal lipid core burden index threshold for randomization to a distal protection filter. Periprocedural MI did not significantly differ in patients who had the filter compared with those who did not (filter, 35.7%; no filter, 23.5%; relative risk = 1.52; 95% CI, 0.5-4.6). – by Erik Swain
Disclosures: Stone reports past consulting for Boston Scientific, Volcano and InfraReDx. See the full study for the other researchers’ relevant financial disclosures.
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