AUTHOR=Ota Hideaki , Matsuo Hitoshi , Imai Shunsuke , Nakashima Yuki , Kawase Yoshiaki , Okubo Munenori , Takahashi Hiroshi , Kawai Hideki , Sobue Yoshihiro , Kawasaki Masanori , Kondo Takeshi , Muramatsu Takashi , Izawa Hideo 

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

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1127121

DOI=10.3389/fcvm.2023.1127121

ISSN=2297-055X

ABSTRACT=<sec><title>Background</title><p>This 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).</p></sec><sec><title>Methods</title><p>We 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; <italic>n</italic> = 48) and no-LRP group (maxLCBI4mm &lt; 400; <italic>n</italic> = 59). Periprocedural myocardial injury was a postprocedural cardiac troponin T (cTnT) elevation of ≥5 times the upper limit of normal.</p></sec><sec><title>Results</title><p>The LRP group had a significantly higher cTnT (<italic>p</italic> = 0.026), lower CT density (<italic>p</italic> &lt; 0.001), larger percentage atheroma volume (PAV) by NIRS–IVUS (<italic>p</italic> = 0.036), and larger remodeling index measured by both CCTA (<italic>p</italic> = 0.020) and NIRS–IVUS (<italic>p</italic> &lt; 0.001). A significant negative linear correlation was found between maxLCBI4mm and CT density (rho = −0.552, <italic>p</italic> &lt; 0.001). Multivariable logistic regression analysis identified maxLCBI4mm [odds ratio (OR): 1.006, <italic>p</italic> = 0.003] and PAV (OR: 1.125, <italic>p</italic> = 0.014) as independent predictors of periprocedural myocardial injury, while CT density was not an independent predictor (OR: 0.991, <italic>p</italic> = 0.22).</p></sec><sec><title>Conclusion</title><p>CCTA 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.</p></sec>