The feasibility and limitation of coronary computed tomographic angiography imaging to identify coronary lipid-rich atheroma in vivo: Findings from near-infrared spectroscopy analysis

Kitahara, Satoshi; Kataoka, Yasufumi; Miura, Hiroyuki; Nishii, Tatsuya; Nishimura, Kunihiro; Murai, Kota; Iwai, Takamasa; Nakamura, Hayato; Hosoda, Hayato; Matama, Hideo; Doi, Takahito; Nakashima, Takahiro; Honda, Satoshi; Fujino, Masashi; Nakao, Kazuhiro; Yoneda, Shuichi; Nishihira, Kensaku; Kanaya, Tomoaki; Otsuka, Fumiyuki; Asaumi, Yasuhide; Tsujita, Kenichi; Noguchi, Teruo; Yasuda, Satoshi

doi:10.1016/j.atherosclerosis.2021.02.019

Cited by 10 publications

(6 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although CCTA is widely used, its cost, risk of contrast nephropathy, radiation exposure, and patient-dependent imaging quality limit its usage. 49 Our study demonstrated the benefit of the SII index, which is an easily calculated and low-cost parameter in addition to traditional risk factors.…”

Section: Discussionmentioning

confidence: 60%

Comparison of Systemic Immune-Inflammation Index and Naples Prognostic Score for Prediction Coronary Artery Severity Patients Undergoing Coronary Computed Tomographic Angiography

et al. 2023

View full text Add to dashboard Cite

This study compared the predictive power of the systemic immune-inflammation index (SII) and Naples prognostic score (NPS) in determining the severity of coronary artery disease (CAD). The study included 1138 patients who underwent coronary computed tomographic angiography (CCTA). The primary outcome was the evaluation of CAD severity, determined by the Coronary Artery Disease-Reporting and Data System (CAD-RADS) obtained from the CCTA scans. A basic statistical model including age, gender, chest pain, diabetes mellitus, hypertension, hyperlipidemia, and smoking was built, and categorical variables, NPS (Naples 3,4 vs 0,1,2) and SII, were added to the basic statistical model. The net benefits of the predictive parameters were determined by a decision curve analysis, and the association between CAD-RADS and NPS, SII was quantified by odds ratios (OR) and 95% confidence intervals (CI). The decision curve analysis showed that adding SII to the statistical model had a better full range of probability of clinical net benefit compared with the baseline model (OR: 5.77, 95% CI 4.15–8.02, P < .001). However, adding the NPS ( P = .11) to the model did not outperform the basic statistical model. In conclusion, the SII may have a net predictive effect on top of traditional risk factors.

show abstract

Section: Discussionmentioning

confidence: 60%

Comparison of Systemic Immune-Inflammation Index and Naples Prognostic Score for Prediction Coronary Artery Severity Patients Undergoing Coronary Computed Tomographic Angiography

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Although the spatial resolution is still limited, advancements in CCTA have allowed for the quantification of coronary atherosclerotic characteristics throughout the entire coronary, with high diagnostic performance compared with invasive reference standards ( 16 – 18 ). Moreover, recent studies showed that the additive value of CCTA-defined APCs in predicting future MACEs ( 6 , 19 – 24 ) is consistent with the results of univariate regression analysis in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…Non-invasive analysis of APCs based on coronary computed tomography angiography (CCTA) has been validated against intravascular ultrasonography (IVUS) ( 16 ), optical coherence tomography (OCT) ( 17 ), and near-infrared spectroscopy (NIRS) ( 18 ), and it showed important value in the prediction of future MACEs ( 6 , 19 – 26 ). However, these CCTA-based studies investigating the association between APCs and prognosis were susceptible to clinical intervention, such as medication and PCI, leading to the uncertainty of lesions responsible for unanticipated MACEs ( 6 , 19 – 25 ).…”

Section: Introductionmentioning

confidence: 99%

Identification of vulnerable non-culprit lesions by coronary computed tomography angiography in patients with chronic coronary syndrome and diabetes mellitus

Zhao

Zhang

Liu

et al. 2023

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

BackgroundAmong patients with diabetes mellitus (DM) and chronic coronary syndrome (CCS), non-culprit lesions (NCLs) are responsible for a substantial number of future major adverse cardiovascular events (MACEs). Thus, we aimed to establish the natural history relationship between adverse plaque characteristics (APCs) of NCLs non-invasively identified by coronary computed tomography angiography (CCTA) and subsequent MACEs in these patients.MethodsBetween January 2016 and January 2019, 523 patients with DM and CCS were included in the present study after CCTA and successful percutaneous coronary intervention (PCI). All patients were followed up for MACEs (the composite of cardiac death, myocardial infarction, and unplanned coronary revascularization) until January 2022, and the independent clinical event committee classified MACEs as indeterminate, culprit lesion (CL), and NCL-related. The primary outcome was MACEs arising from untreated NCLs during the follow-up. The association between plaque characteristics detected by CCTA and primary outcomes was determined by Marginal Cox proportional hazard regression.ResultsOverall, 1,248 NCLs of the 523 patients were analyzed and followed up for a median of 47 months. The cumulative rates of indeterminate, CL, and NCL-related MACEs were 2.3%, 14.5%, and 20.5%, respectively. On multivariate analysis, NCLs associated with recurrent MACEs were more likely to be characterized by a plaque burden >70% [hazard ratio (HR), 4.35, 95% confidence interval (CI): 2.92–6.44], a low-density non-calcified plaque (LDNCP) volume >30 mm3 (HR: 3.40, 95% CI: 2.07–5.56), a minimal luminal area (MLA) <4 mm2 (HR: 2.30, 95% CI: 1.57–3.36), or a combination of three APCs (HR: 13.69, 95% CI: 9.34–20.12, p < 0.0001) than those not associated with recurrent MACEs. Sensitivity analysis regarding all indeterminate MACEs as NCL-related ones demonstrated similar results.ConclusionsIn DM patients who presented with CCS and underwent PCI, half of the MACEs occurring during the follow-up were attributable to recurrence at the site of NCLs. NCLs responsible for unanticipated MACEs were frequently characterized by a large plaque burden and LDNCP volume, a small MLA, or a combination of these APCs, as determined by CCTA.

show abstract

“…A recent study showed that the group with a larger maxLCBI4mm had a smaller CT density and a higher proportion of napkin-ring signs ( 19 ). In addition, our results revealed that maxLCBI4mm has a linear inverse correlation with CT density.…”

Section: Discussionmentioning

confidence: 99%

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

Ota

Matsuo²,

Imai³

et al. 2023

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

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.

show abstract

The feasibility and limitation of coronary computed tomographic angiography imaging to identify coronary lipid-rich atheroma in vivo: Findings from near-infrared spectroscopy analysis

Cited by 10 publications

References 27 publications

Comparison of Systemic Immune-Inflammation Index and Naples Prognostic Score for Prediction Coronary Artery Severity Patients Undergoing Coronary Computed Tomographic Angiography

Comparison of Systemic Immune-Inflammation Index and Naples Prognostic Score for Prediction Coronary Artery Severity Patients Undergoing Coronary Computed Tomographic Angiography

Identification of vulnerable non-culprit lesions by coronary computed tomography angiography in patients with chronic coronary syndrome and diabetes mellitus

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

Contact Info

Product

Resources

About