Frontiers in Cardiovascular Medicine (Mar 2023)

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

  • Hideaki Ota,
  • Hideaki Ota,
  • Hitoshi Matsuo,
  • Shunsuke Imai,
  • Yuki Nakashima,
  • Yoshiaki Kawase,
  • Munenori Okubo,
  • Hiroshi Takahashi,
  • Hideki Kawai,
  • Yoshihiro Sobue,
  • Yoshihiro Sobue,
  • Masanori Kawasaki,
  • Takeshi Kondo,
  • Takashi Muramatsu,
  • Hideo Izawa

DOI
https://doi.org/10.3389/fcvm.2023.1127121
Journal volume & issue
Vol. 10

Abstract

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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.

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