1. Optical coherence tomography-derived lipid core burden index and clinical outcomes: results from the CLIMA registry.
- Author
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Biccirè, Flavio Giuseppe, Budassi, Simone, Ozaki, Yukio, Boi, Alberto, Romagnoli, Enrico, Pietro, Riccardo Di, Bourantas, Christos V, Marco, Valeria, Paoletti, Giulia, Debelak, Caterina, Sammartini, Emanuele, Versaci, Francesco, Fabbiocchi, Franco, Burzotta, Francesco, Pastori, Daniele, Crea, Filippo, Arbustini, Eloisa, Alfonso, Fernando, and Prati, Francesco
- Subjects
RESEARCH ,SCIENTIFIC observation ,CONFIDENCE intervals ,MANN Whitney U Test ,T-test (Statistics) ,OPTICAL coherence tomography ,CORONARY artery disease ,DESCRIPTIVE statistics ,CHI-squared test ,KAPLAN-Meier estimator ,RESEARCH funding ,DATA analysis software ,ODDS ratio ,LONGITUDINAL method ,SECONDARY analysis - Abstract
Aims The aim of this study was to assess the morphological characteristics and prognostic implications of the optical coherence tomography (OCT)-derived lipid core burden index (LCBI). Methods and results OCT-LCBI was assessed in 1003 patients with 1-year follow-up from the CLIMA multicentre registry using a validated software able to automatically obtain a maximum OCT-LCBI in 4 mm (maxOCT-LCBI
4mm ). Primary composite clinical endpoint included cardiac death, myocardial infarction, and target-vessel revascularization. A secondary analysis using clinical outcomes of CLIMA study was performed. Patients with a maxOCT-LCBI4mm ≥ 400 showed higher prevalence of fibrous cap thickness (FCT) <75 μm [odds ratio (OR) 1.43, 95% confidence interval (CI) 1.03–1.99; P = 0.034], lipid pool arc >180° (OR 3.93, 95%CI 2.97–5.21; P < 0.001), minimum lumen area <3.5 mm2 (OR 1.5, 95%CI 1.16–1.94; P = 0.002), macrophage infiltration (OR 2.38, 95%CI 1.81–3.13; P < 0.001), and intra-plaque intimal vasculature (OR 1.34, 95%CI 1.05–1.72; P = 0.021). A maxOCT-LCBI4mm ≥400 predicted the primary endpoint [adjusted hazard ratio (HR) 1.86, 95%CI 1.1–3.2; P = 0.019] as well as the CLIMA endpoint (HR 2.56, 95%CI 1.24–5.29; P = 0.011). Patients with high lipid content and thin FCT < 75 µm were at higher risk for adverse events (HR 4.88, 95%CI 2.44–9.72; P < 0.001). Conclusions A high maxOCT-LCBI4mm was related to poor outcome and vulnerable plaque features. This study represents a step further in the automated assessment of the coronary plaque risk profile. [ABSTRACT FROM AUTHOR]- Published
- 2023
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