Long-term follow-up after near-infrared spectroscopy coronary imaging: Insights from the lipid cORe plaque association with CLinical events (ORACLE-NIRS) registry

Barbara Anna Danek, Aris Karatasakis, Judit Karacsonyi, Aya Alame, Erica Resendes, Pratik Kalsaria, Phuong Khanh J Nguyen-Trong, Bavana V. Rangan, Michele Roesle, Shuaib Abdullah, Subhash Banerjee, Emmanouil S. Brilakis

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Coronary lipid core plaque may be associated with the incidence of subsequent cardiovascular events. Methods: We analyzed outcomes of 239 patients who underwent near-infrared spectroscopy (NIRS) coronary imaging between 2009-2011. Multivariable Cox regression was used to identify variables independently associated with the incidence of major adverse cardiovascular events (MACE; cardiac mortality, acute coronary syndromes (ACS), stroke, and unplanned revascularization) during follow-up. Results: Mean patient age was 64. ±. 9. years, 99% were men, and 50% were diabetic, presenting with stable coronary artery disease (61%) or an acute coronary syndrome (ACS, 39%). Target vessel pre-stenting median lipid core burden index (LCBI) was 88 [interquartile range, IQR 50-130]. Median LCBI in non-target vessels was 57 [IQR 26-94]. Median follow-up was 5.3. years. The 5-year MACE rate was 37.5% (cardiac mortality was 15.0%). On multivariable analysis the following variables were associated with MACE: diabetes mellitus, prior percutaneous coronary intervention performed at index angiography, and non-target vessel LCBI. Non-target vessel LCBI of 77 was determined using receiver-operating characteristic curve analysis to be a threshold for prediction of MACE in our cohort. The adjusted hazard ratio (HR) for non-target vessel LCBI ≥77 was 14.05 (95% confidence interval (CI) 2.47-133.51, p. =0.002). The 5-year cumulative incidence of events in the above-threshold group was 58.0% vs. 13.1% in the below-threshold group. Conclusion: During long-term follow-up of patients who underwent NIRS imaging, high LCBI in a non-PCI target vessel was associated with increased incidence of MACE.

Original languageEnglish (US)
JournalCardiovascular Revascularization Medicine
DOIs
StateAccepted/In press - Sep 3 2016

Fingerprint

Near-Infrared Spectroscopy
Registries
Lipids
Acute Coronary Syndrome
Incidence
Mortality
Percutaneous Coronary Intervention
ROC Curve
Coronary Artery Disease
Diabetes Mellitus
Angiography
Stroke
Confidence Intervals

Keywords

  • Coronary artery disease
  • Intravascular imaging
  • Near-infrared spectroscopy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Long-term follow-up after near-infrared spectroscopy coronary imaging : Insights from the lipid cORe plaque association with CLinical events (ORACLE-NIRS) registry. / Danek, Barbara Anna; Karatasakis, Aris; Karacsonyi, Judit; Alame, Aya; Resendes, Erica; Kalsaria, Pratik; Nguyen-Trong, Phuong Khanh J; Rangan, Bavana V.; Roesle, Michele; Abdullah, Shuaib; Banerjee, Subhash; Brilakis, Emmanouil S.

In: Cardiovascular Revascularization Medicine, 03.09.2016.

Research output: Contribution to journalArticle

Danek, Barbara Anna ; Karatasakis, Aris ; Karacsonyi, Judit ; Alame, Aya ; Resendes, Erica ; Kalsaria, Pratik ; Nguyen-Trong, Phuong Khanh J ; Rangan, Bavana V. ; Roesle, Michele ; Abdullah, Shuaib ; Banerjee, Subhash ; Brilakis, Emmanouil S. / Long-term follow-up after near-infrared spectroscopy coronary imaging : Insights from the lipid cORe plaque association with CLinical events (ORACLE-NIRS) registry. In: Cardiovascular Revascularization Medicine. 2016.
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abstract = "Background: Coronary lipid core plaque may be associated with the incidence of subsequent cardiovascular events. Methods: We analyzed outcomes of 239 patients who underwent near-infrared spectroscopy (NIRS) coronary imaging between 2009-2011. Multivariable Cox regression was used to identify variables independently associated with the incidence of major adverse cardiovascular events (MACE; cardiac mortality, acute coronary syndromes (ACS), stroke, and unplanned revascularization) during follow-up. Results: Mean patient age was 64. ±. 9. years, 99{\%} were men, and 50{\%} were diabetic, presenting with stable coronary artery disease (61{\%}) or an acute coronary syndrome (ACS, 39{\%}). Target vessel pre-stenting median lipid core burden index (LCBI) was 88 [interquartile range, IQR 50-130]. Median LCBI in non-target vessels was 57 [IQR 26-94]. Median follow-up was 5.3. years. The 5-year MACE rate was 37.5{\%} (cardiac mortality was 15.0{\%}). On multivariable analysis the following variables were associated with MACE: diabetes mellitus, prior percutaneous coronary intervention performed at index angiography, and non-target vessel LCBI. Non-target vessel LCBI of 77 was determined using receiver-operating characteristic curve analysis to be a threshold for prediction of MACE in our cohort. The adjusted hazard ratio (HR) for non-target vessel LCBI ≥77 was 14.05 (95{\%} confidence interval (CI) 2.47-133.51, p. =0.002). The 5-year cumulative incidence of events in the above-threshold group was 58.0{\%} vs. 13.1{\%} in the below-threshold group. Conclusion: During long-term follow-up of patients who underwent NIRS imaging, high LCBI in a non-PCI target vessel was associated with increased incidence of MACE.",
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author = "Danek, {Barbara Anna} and Aris Karatasakis and Judit Karacsonyi and Aya Alame and Erica Resendes and Pratik Kalsaria and Nguyen-Trong, {Phuong Khanh J} and Rangan, {Bavana V.} and Michele Roesle and Shuaib Abdullah and Subhash Banerjee and Brilakis, {Emmanouil S.}",
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T1 - Long-term follow-up after near-infrared spectroscopy coronary imaging

T2 - Insights from the lipid cORe plaque association with CLinical events (ORACLE-NIRS) registry

AU - Danek, Barbara Anna

AU - Karatasakis, Aris

AU - Karacsonyi, Judit

AU - Alame, Aya

AU - Resendes, Erica

AU - Kalsaria, Pratik

AU - Nguyen-Trong, Phuong Khanh J

AU - Rangan, Bavana V.

AU - Roesle, Michele

AU - Abdullah, Shuaib

AU - Banerjee, Subhash

AU - Brilakis, Emmanouil S.

PY - 2016/9/3

Y1 - 2016/9/3

N2 - Background: Coronary lipid core plaque may be associated with the incidence of subsequent cardiovascular events. Methods: We analyzed outcomes of 239 patients who underwent near-infrared spectroscopy (NIRS) coronary imaging between 2009-2011. Multivariable Cox regression was used to identify variables independently associated with the incidence of major adverse cardiovascular events (MACE; cardiac mortality, acute coronary syndromes (ACS), stroke, and unplanned revascularization) during follow-up. Results: Mean patient age was 64. ±. 9. years, 99% were men, and 50% were diabetic, presenting with stable coronary artery disease (61%) or an acute coronary syndrome (ACS, 39%). Target vessel pre-stenting median lipid core burden index (LCBI) was 88 [interquartile range, IQR 50-130]. Median LCBI in non-target vessels was 57 [IQR 26-94]. Median follow-up was 5.3. years. The 5-year MACE rate was 37.5% (cardiac mortality was 15.0%). On multivariable analysis the following variables were associated with MACE: diabetes mellitus, prior percutaneous coronary intervention performed at index angiography, and non-target vessel LCBI. Non-target vessel LCBI of 77 was determined using receiver-operating characteristic curve analysis to be a threshold for prediction of MACE in our cohort. The adjusted hazard ratio (HR) for non-target vessel LCBI ≥77 was 14.05 (95% confidence interval (CI) 2.47-133.51, p. =0.002). The 5-year cumulative incidence of events in the above-threshold group was 58.0% vs. 13.1% in the below-threshold group. Conclusion: During long-term follow-up of patients who underwent NIRS imaging, high LCBI in a non-PCI target vessel was associated with increased incidence of MACE.

AB - Background: Coronary lipid core plaque may be associated with the incidence of subsequent cardiovascular events. Methods: We analyzed outcomes of 239 patients who underwent near-infrared spectroscopy (NIRS) coronary imaging between 2009-2011. Multivariable Cox regression was used to identify variables independently associated with the incidence of major adverse cardiovascular events (MACE; cardiac mortality, acute coronary syndromes (ACS), stroke, and unplanned revascularization) during follow-up. Results: Mean patient age was 64. ±. 9. years, 99% were men, and 50% were diabetic, presenting with stable coronary artery disease (61%) or an acute coronary syndrome (ACS, 39%). Target vessel pre-stenting median lipid core burden index (LCBI) was 88 [interquartile range, IQR 50-130]. Median LCBI in non-target vessels was 57 [IQR 26-94]. Median follow-up was 5.3. years. The 5-year MACE rate was 37.5% (cardiac mortality was 15.0%). On multivariable analysis the following variables were associated with MACE: diabetes mellitus, prior percutaneous coronary intervention performed at index angiography, and non-target vessel LCBI. Non-target vessel LCBI of 77 was determined using receiver-operating characteristic curve analysis to be a threshold for prediction of MACE in our cohort. The adjusted hazard ratio (HR) for non-target vessel LCBI ≥77 was 14.05 (95% confidence interval (CI) 2.47-133.51, p. =0.002). The 5-year cumulative incidence of events in the above-threshold group was 58.0% vs. 13.1% in the below-threshold group. Conclusion: During long-term follow-up of patients who underwent NIRS imaging, high LCBI in a non-PCI target vessel was associated with increased incidence of MACE.

KW - Coronary artery disease

KW - Intravascular imaging

KW - Near-infrared spectroscopy

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U2 - 10.1016/j.carrev.2016.12.006

DO - 10.1016/j.carrev.2016.12.006

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