Near-Infrared Spectroscopy Predicts Cardiovascular Outcome in Patients With Coronary Artery Disease
Near-Infrared Spectroscopy Predicts Cardiovascular Outcome in Patients With Coronary Artery Disease
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DOI：
10.1016/j.jacc.2014.07.998
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发表时间：
2014-12-16
影响因子：
24
通讯作者：
Boersma, Eric
中科院分区：
文献类型：
--
作者：
Oemrawsingh, Rohit M.;Cheng, Jin M.;Boersma, Eric
背景近红外光谱（NIRS）能够识别含有脂质核心的斑块，其随后可以被量化为脂质核心负荷指数（LCBI）。目前，没有关于NIRS在冠状动脉疾病（CAD）患者中的长期预后价值的数据。结论本研究试图确定冠状动脉内NIRS在CAD患者的非罪犯血管中评估的长期预后价值。对203例因稳定型心绞痛（SAP）或急性冠状动脉综合征（ACS）而接受血管造影的患者的非罪犯冠状动脉进行近红外光谱成像。主要终点是全因死亡率、非致死性ACS、卒中和计划外冠状动脉血运重建的复合终点。LCBI等于或高于中位数（43.0）的患者与LCBI值低于中位数的患者的累积1年发生率分别为16.7%和4.0%（校正风险比：4.04; 95%置信区间：1.33 - 12.29; p = 0.01）。SAP和ACS患者中LCBI与主要终点之间的关系相似（异质性p值= 0.14）。相似的差异之间的高和低LCBI观察在预先规定的次要endpoints.CONCLUSION CAD患者的LCBI等于或高于中位数43.0，评估NIRS在非罪犯冠状动脉，有4倍的风险不良心血管事件在1年的后续行动。这一观察结果需要通过更大规模的研究和长期随访来证实。(C)2014年由美国心脏病学会基金会。
BACKGROUND Near-infrared spectroscopy (NIRS) is capable of identifying lipid core-containing plaques, which can subsequently be quantified as a lipid core burden index (LCBI). Currently, no data are available on the long-term prognostic value of NIRS in patients with coronary artery disease (CAD).OBJECTIVES This study sought to determine the long-term prognostic value of intracoronary NIRS as assessed in a nonculprit vessel in patients with CAD.METHODS In this prospective, observational study, NIRS imaging was performed in a nonculprit coronary artery in 203 patients referred for angiography due to stable angina pectoris (SAP) or acute coronary syndrome (ACS). The primary endpoint was the composite of all-cause mortality, nonfatal ACS, stroke, and unplanned coronary revascularization.RESULTS The 1-year cumulative incidence of the primary endpoint was 10.4%. Cumulative 1-year rates in patients with an LCBI equal to and above the median (43.0) versus those with LCBI values below the median were 16.7% versus 4.0% (adjusted hazard ratio: 4.04; 95% confidence interval: 1.33 to 12.29; p = 0.01). The relation between LCBI and the primary endpoint was similar in SAP and ACS patients (p value for heterogeneity = 0.14). Similar differences between high and low LCBI were observed in pre-specified secondary endpoints.CONCLUSION CAD patients with an LCBI equal to or above the median of 43.0, as assessed by NIRS in a nonculprit coronary artery, had a 4-fold risk of adverse cardiovascular events during 1-year follow-up. This observation warrants confirmation by larger studies with extended follow-up. (C) 2014 by the American College of Cardiology Foundation.