Large lipid-rich coronary plaques detected by near-infrared spectroscopy at non-stented sites in the target artery identify patients likely to experience future major adverse cardiovascular events

Madder, Ryan D.; Husaini, Mustafa; Davis, Alan T.; VanOosterhout, Stacie; Khan, Mohsin; Wohns, David; McNamara, Richard; Wolschleger, Kevin; Gribar, John J.; Collins, John; Jacoby, Mark; Decker, Jeffrey; Hendricks, Michael J.; Sum, Stephen T.; Madden, Sean; Ware, James H.; Muller, James E.

doi:10.1093/ehjci/jev340

Cited by 78 publications

(47 citation statements)

References 24 publications

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“…The results showed that the presence of large LCP in a non-stented segment, defined by NIRS maxLCBI 4mm ≥400 at baseline, was associated with a significantly increased risk of future MACCE during follow-up (HR 10.2, 95% CI: 3.4-30.6; P < 0.001). This study, although single center, underpowered, and with limited follow-up, was consistent with the findings of ATHEROREMO-NIRS study, whereas NIRS detection of lipid burden was associated with patient-level risk of future MACCE [93].…”

Section: Assessing Plaque Vulnerability and Risk Stratificationsupporting

confidence: 86%

“…Although these results are promising, the number of events in this trial was small, and therefore studies with larger number of events will be required for the validation of vulnerable patient detection with NIRS-IVUS imaging. A more recent NIRS-IVUS single-center registry study was conducted in 121 consecutive patients undergoing combined NIRS and IVUS imaging to evaluate the association of large lipid-rich plaques at non-stented sites in a target vessel and subsequent major adverse cardiovascular and cere-brovascular events (MACCE) [93]. The results showed that the presence of large LCP in a non-stented segment, defined by NIRS maxLCBI 4mm ≥400 at baseline, was associated with a significantly increased risk of future MACCE during follow-up (HR 10.2, 95% CI: 3.4-30.6; P < 0.001).…”

Section: Assessing Plaque Vulnerability and Risk Stratificationmentioning

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: Assessing Plaque Vulnerability and Risk Stratificationsupporting

confidence: 86%

Section: Assessing Plaque Vulnerability and Risk Stratificationmentioning

confidence: 99%

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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show abstract

“…It is also worth noting that the extended SWIR range may be considered for brain imaging based on the endogenous contrast originated from the distinctive spectral features of the tissue constituents in this region (eg, the existence of the close but not overlapping intense absorption bands of lipids at 2165 nm, proteins around 2300 nm and water near 2480 nm). In particular, taking into account a high lipid content of a brain tissue [77] and the reported use of SWIR and SWIR-II windows for IR spectroscopy to detect/localize lipids ex vivo [41][42][43] and in vivo [78][79][80][81], an approach utilizing extended SWIR region for lipid-based brain imaging can be suggested.…”

Section: Light Penetration Depthmentioning

confidence: 99%

Optical windows for head tissues in near‐infrared and short‐wave infrared regions: Approaching transcranial light applications

Golovynskyi

Golovynska

Stepanova

et al. 2018

Journal of Biophotonics

164

125

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Optical properties of the rat head tissues (brain cortex, cranial bone and scalp skin) are assessed, aiming at transcranial light applications such as optical imaging and phototherapy. The spectral measurements are carried out over the wide spectral range of 350 to 2800 nm, involving visible, near-infrared (NIR) and short-wave infrared (SWIR) regions. Four tissue transparency windows are considered: ~700 to 1000 nm (NIR-I), ~1000 to 1350 nm (NIR-II), ~1550 to 1870 nm (NIR-III or SWIR) and ~2100 to 2300 nm (SWIR-II). The values of attenuation coefficient and total attenuation length are determined for all windows and tissue types. The spectra indicate transmittance peaks in NIR, NIR-II and SWIR-II, with maximum tissue permeability for SWIR light. The use of SWIR-II window for the transcranial light applications is substantiated. Furthermore, absorbance of the head tissues is investigated in details, by defining and describing the characteristic absorption peaks in NIR-SWIR.

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“…Moreover, to rule out plaque rupture in survivors of SCD with non-obstructive intermediate lesion, OCT own a potential advantage over IVUS given its higher spatial resolution. Other modality such as near infrared spectroscopy could be of value in the future[7,8]. …”

Section: Discussionmentioning

confidence: 99%

Optical coherence tomography to identify the cause of an arrhythmic storm: A case report

Couture

Bérubé

Daneault

2017

WJC

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A 56-year-old man experienced an aborted sudden death followed by an arrhythmic storm. Angiography revealed a non-severe lesion on the left circumflex artery that was treated medically but an arrhythmic storm recurred. A repeat angiogram was comparable but optical coherence tomography imaging revealed a ruptured plaque with intraluminal thrombosis. Percutaneous coronary intervention was performed and no arrhythmia recurred.

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Large lipid-rich coronary plaques detected by near-infrared spectroscopy at non-stented sites in the target artery identify patients likely to experience future major adverse cardiovascular events

Abstract: Detection of large LRP by NIRS at non-stented sites in a target artery was associated with an increased risk of future MACCE. These findings support ongoing prospective studies to further evaluate the ability of NIRS to identify vulnerable patients.

Cited by 78 publications

References 24 publications

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

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

Optical windows for head tissues in near‐infrared and short‐wave infrared regions: Approaching transcranial light applications

Optical coherence tomography to identify the cause of an arrhythmic storm: A case report

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