Saphenous vein graft near-infrared spectroscopy imaging insights from the lipid core plaque association with clinical events near-infrared spectroscopy (ORACLE-NIRS) registry

Barbara A. Danek, Aris Karatasakis, Aya J. Alame, Phuong Khanh J Nguyen-Trong, Judit Karacsonyi, Bavana Rangan, Michele Roesle, Amy Atwell, Erica Resendes, Jose Roberto Martinez-Parachini, Rahel Iwnetu, Pratik Kalsaria, Furqan Siddiqui, James E. Muller, Subhash Banerjee, Emmanouil Brilakis

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Objectives: We sought to examine near-infrared spectroscopy (NIRS) imaging findings of aortocoronary saphenous vein grafts (SVGs). Background: SVGs are prone to develop atherosclerosis similar to native coronary arteries. They have received little study using NIRS. Methods: We examined the clinical characteristics and imaging findings from 43 patients who underwent NIRS imaging of 45 SVGs at our institution between 2009 and 2016. Results: The mean patient age was 67 ± 7 years and 98% were men, with high prevalence of diabetes mellitus (56%), hypertension (95%), and dyslipidemia (95%). Mean SVG age was 7 ± 7 years, mean SVG lipid core burden index (LCBI) was 53 ± 60 and mean maxLCBI4 mm was 194 ± 234. Twelve SVGs (27%) had lipid core plaques (2 yellow blocks on the block chemogram), with a higher prevalence in SVGs older than 5 years (46% vs. 5%, P = 0.002). Older SVG age was associated with higher LCBI (r = 0.480, P < 0.001) and higher maxLCBI4 mm (r = 0.567, P < 0.001). On univariate analysis, greater annual total cholesterol exposure was associated with higher SVG LCBI (r = 0.30, P = 0.042) and annual LDL-cholesterol and triglyceride exposure were associated with higher SVG maxLCBI4 mm (LDL-C: r = 0.41, P = 0.020; triglycerides: r = 0.36, P = 0.043). On multivariate analysis, the only independent predictor of SVG LCBI and maxLCBI4mm was SVG age. SVG percutaneous coronary intervention was performed in 63% of the patients. An embolic protection device was used in 96% of SVG PCIs. Periprocedural myocardial infarction occurred in one patient. Conclusions: Older SVG age and greater lipid exposure are associated with higher SVG lipid burden.

Original languageEnglish (US)
Pages (from-to)E172-E180
JournalCatheterization and Cardiovascular Interventions
Volume89
Issue number6
DOIs
StatePublished - May 2017

Keywords

  • lipids
  • saphenous vein bypass graft
  • saphenous vein graft interventions

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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