Relation Between the Presence and Extent of Coronary Lipid Core Plaques Detected by Near-Infrared Spectroscopy With Postpercutaneous Coronary Intervention Myocardial Infarction

Raghunathan, Deepa; Abdel-Karim, Abdul Rahman R; Papayannis, Aristotelis; DaSilva, Marcelo C.; Jeroudi, Omar M.; Rangan, Bavana V.; Banerjee, Subhash; Brilakis, Emmanouil S.

doi:10.1016/j.amjcard.2011.01.044

Cited by 35 publications

(24 citation statements)

References 21 publications

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“…The authors concluded that a high LCP, defined as a maxLCBI 4mm ≥ 500, was associated with periprocedural events. These results are concordant with the registry study conducted by Raghunathan et al [21], in which the analysis of 30 patients who underwent pre-procedure NIRS imaging showed a postprocedural increase of CK-MB more than three times the UNL in 27% of patients with a ≥1 yellow blocks (n = 11) as opposed to none in the 19 patients without a yellow block within the stented lesion.…”

Section: Prevention Of Periprocedural Complicationssupporting

confidence: 81%

“…Stone et al showed in the CANARY trial that LCP measured as LCBI by NIRS in the stented vessels reduces with PCI treatment, with a significant reduction of median LCBI from 143.2 before PCI to 17.9 after PCI (P < 0.001) [125]. Moreover, the authors showed that the occurrence of periprocedural MI was associated with higher LCBI, results that are concordant with previous findings [20,21].…”

Section: Prevention Of Periprocedural Complicationssupporting

confidence: 81%

“…This sub-study aims to evaluate the changes in the plaque at 2 years follow-up. Clinically, large LCPs have been shown to be associated with MACE, especially periprocedural myocardial infarction [21]. Whether lipid burden influences long-term outcomes following stent implantation remains elusive.…”

Section: Optimizing Percutaneous Coronary Intervention Proceduresmentioning

confidence: 99%

“…In 2001, a device prototype for intracoronary imaging was developed, which led to multiple case series and clinical studies in the following decade [13][14][15]. This technology aims to detect vulnerable lipid-rich plaques (LRPs) by NIRS chemogram [16], whereas recent literature has demonstrated the association of LRP and culprit lesions in ACS [17,18], as well as with nonculprit lesions in ACS [19], in percutaneous coronary intervention (PCI)-related procedural complications [20,21], in plaque regression with statins therapy [22] and with the occurrence of cardiovascular events [23]. NIRS received US Food and Drug Administration (FDA) approval for clinical use in 2008 and for NIRS-IVUS system in 2010, followed by regulatory approval in Europe (CE marked) and Japan in 2011 and 2014, respectively (e.g., Figure 1) [24].…”

Section: Introductionmentioning

confidence: 99%

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Near-Infrared Spectroscopy (NIRS): A Novel Tool for Intravascular Coronary Imaging

Bertrand¹,

Lavoie-L'Allier²,

Jean-ClaudeTardif³

2017

Developments in Near-Infrared Spectroscopy

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Acute coronary syndrome (ACS) arising from plaque rupture is the leading cause of mortality worldwide. Near-infrared spectroscopy (NIRS) combined with intravascular ultrasound (NIRS-IVUS) is a novel catheter-based intravascular imaging modality that provides a chemogram of the coronary artery wall, which enables the detection of lipid core and specific quantification of lipid accumulation measured as the lipid-core burden index (LCBI) in patients undergoing coronary angiography. Recent studies have shown that NIRS-IVUS can identify vulnerable plaques and vulnerable patients associated with increased risk of adverse cardiovascular events, whereas an increased coronary plaque LCBI may predict a higher risk of future cardiovascular events and periprocedural events. NIRS is a promising tool for the detection of vulnerable plaques in CAD patients, PCI-guidance procedures, and assessment of lipid-lowering therapies. Previous trials have evaluated the impact of statin therapy on coronary NIRS defined lipid cores, whereas NIRS could further be used as a surrogate end point of future ACS in phase II clinical trials evaluating novel anti-atheromatous drug therapies. Multiple ongoing studies address the different potential clinical applications of NIRS-IVUS imaging as a valuable tool for coronary plaque characterization and predictor of future coronary events in CAD patients.

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Section: Prevention Of Periprocedural Complicationssupporting

confidence: 81%

Section: Prevention Of Periprocedural Complicationssupporting

confidence: 81%

Section: Optimizing Percutaneous Coronary Intervention Proceduresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Near-Infrared Spectroscopy (NIRS): A Novel Tool for Intravascular Coronary Imaging

Bertrand¹,

Lavoie-L'Allier²,

Jean-ClaudeTardif³

2017

Developments in Near-Infrared Spectroscopy

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“…[56][57][58][59] In a study of 30 patients undergoing native coronary PCI, postprocedural CK-MB level elevation >3 times the ULN was observed in 27% of patients with ≥2 2-mm yellow blocks on the block chemogram versus none with 0 to 1 yellow block within the stented lesion (P=0.02). 60 In a subset of 62 patients from the Chemometric Observation of LCP of Interest in Native Coronary Arteries Registry (COLOR) without preprocedural biomarker elevation or suspected intracoronary thrombus, the incidence of post-PCI MI was significantly higher at 50% (7 of 14 patients) among patients with maximal LCBI measured by NIRS for each of the 4 mm longitudinal segments in the treatment zone (maxLCBI 4mm ) of ≥500 versus 4.2% (2 of 48 patients) with maxLCBI 4mm <500 (P=0.0002). 61 An EPD ( Figure 4C) was used in 9 patients with large LCPs undergoing PCI 62 with capture of embolized material in 8 of 9 lesions (89%), mainly consisting of fibrin and platelet aggregates.…”

Section: Near-infrared Spectroscopymentioning

confidence: 99%

Intracoronary and Noninvasive Imaging for Prediction of Distal Embolization and Periprocedural Myocardial Infarction During Native Coronary Artery Percutaneous Intervention

Patel

Brayton

Mintz

et al. 2013

Circ: Cardiovascular Imaging

Self Cite

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T he incidence of periprocedural myocardial infarction (MI) after percutaneous coronary intervention (PCI) ranges from 2% to 50%, depending on the clinical presentation, type of procedure, choice of biomarker (creatine kinase [CK]-MB or troponin), and the threshold used to qualify the diagnosis. 1 Because of this heterogeneity of definition, the prognostic implications of periprocedural MI are controversial. However, several studies have demonstrated that periprocedural MI is associated with worse in-hospital, short-term, and long-term clinical outcomes, including death, recurrent MI, and need for revascularization. [3][4][5] Various mechanisms can lead to periprocedural MI, such as side branch occlusion or vessel spasm; however, distal embolization of atheroma or thrombus seems to be a dominant cause. 6 In a cardiac MRI (cMRI) study of patients undergoing complex native coronary PCI, elevated troponin levels post-PCI correlated with new myocardial enhancement because of side branch occlusion in 43% of cases and in the apical myocardium distal to the stent in 57% of cases, as would be expected with distal embolization. 7Numerous studies have documented the occurrence of distal embolization during both elective and urgent PCI and have characterized its histopathologic substrate. In an analysis of catheter-retrieved materials from human studies of patients undergoing PCI for acute coronary syndrome (ACS), 8 those with no-reflow had significantly higher amounts of visible atheroma and microscopic components such as platelet-fibrin complexes, cholesterol crystals, and macrophages. 8 In another study of 37 lesions in 35 patients undergoing elective PCI, microscopic particles were captured by embolic protection devices (EPDs) in 28 (75.6%) lesions.9 Thrombotic components (fibrin strand-entrapped platelets, leukocytes, and red cells) accounted for the majority (≈75%) of captured debris, whereas plaque components (fibrous tissue, calcium spots, acellular amorphous material, macrophages, foam cells, and cholesterol clefts) accounted for the minority (≈25%).9 Similar findings were demonstrated among 33 patients undergoing either native or saphenous vein graft PCI.10 Supporting these in vivo findings, in a postmortem analysis of patients who died of ischemic heart disease, many had evidence of coronary microemboli, composed of cholesterol crystals, hyaline, and platelet aggregates. 11Clinically, distal embolization can result in asymptomatic biomarker elevation or symptomatic ischemia; angiographically, it can present as visually undetectable silent embolization, macroembolization resulting in epicardial coronary obstruction, or severe microvascular obstruction resulting in no-reflow.Coronary angiography has limited capacity to assess the risk for distal macro-or microembolization. The development of advanced intracoronary imaging techniques and noninvasive imaging techniques, such as coronary computed tomography angiography (CCTA) and cMRI, provides an opportunity for detailed analysis of plaque composition, which can pot...

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Optical Coherence Tomography, Near‐Infrared Spectroscopy, and Near‐Infrared Fluorescence Molecular Imaging

Kılıç

Serdoz

Fabris

et al. 2016

Interventional Cardiology

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Relation Between the Presence and Extent of Coronary Lipid Core Plaques Detected by Near-Infrared Spectroscopy With Postpercutaneous Coronary Intervention Myocardial Infarction

Cited by 35 publications

References 21 publications

Near-Infrared Spectroscopy (NIRS): A Novel Tool for Intravascular Coronary Imaging

Near-Infrared Spectroscopy (NIRS): A Novel Tool for Intravascular Coronary Imaging

Intracoronary and Noninvasive Imaging for Prediction of Distal Embolization and Periprocedural Myocardial Infarction During Native Coronary Artery Percutaneous Intervention

Optical Coherence Tomography, Near‐Infrared Spectroscopy, and Near‐Infrared Fluorescence Molecular Imaging

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