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Identification of vulnerable plaques and patients by intracoronary near-infrared spectroscopy and ultrasound (PROSPECT II) : a prospective natural history study

Identification of vulnerable plaques and patients by intracoronary near-infrared spectroscopy and ultrasound (PROSPECT II) : a prospective natural history study

Authors :
Erlinge, David
Maehara, Akiko
Ben-Yehuda, Ori
Bötker, Hans Erik
Maeng, Michael
Kjöller-Hansen, Lars
Engström, Thomas
Matsumura, Mitsuaki
Crowley, Aaron
Dressler, Ovidiu
Mintz, Gary S.
Fröbert, Ole
Persson, Jonas
Wiseth, Rune
Larsen, Alf Inge
Jensen, Lisette Okkels
Nordrehaug, Jan Erik
Bleie, Öyvind
Omerovic, Elmir
Held, Claes
James, Stefan
Ali, Ziad A.
Muller, James E.
Stone, Gregg W.
Christersson, Christina
Sarno, Giovanna
Erlinge, David
Maehara, Akiko
Ben-Yehuda, Ori
Bötker, Hans Erik
Maeng, Michael
Kjöller-Hansen, Lars
Engström, Thomas
Matsumura, Mitsuaki
Crowley, Aaron
Dressler, Ovidiu
Mintz, Gary S.
Fröbert, Ole
Persson, Jonas
Wiseth, Rune
Larsen, Alf Inge
Jensen, Lisette Okkels
Nordrehaug, Jan Erik
Bleie, Öyvind
Omerovic, Elmir
Held, Claes
James, Stefan
Ali, Ziad A.
Muller, James E.
Stone, Gregg W.
Christersson, Christina
Sarno, Giovanna
Publication Year :
2021

Abstract

Background: Near-infrared spectroscopy (NIRS) and intravascular ultrasound are promising imaging modalities to identify non-obstructive plaques likely to cause coronary-related events. We aimed to assess whether combined NIRS and intravascular ultrasound can identify high-risk plaques and patients that are at risk for future major adverse cardiac events (MACEs). Methods: PROSPECT II is an investigator-sponsored, multicentre, prospective natural history study done at 14 university hospitals and two community hospitals in Denmark, Norway, and Sweden. We recruited patients of any age with recent (within past 4 weeks) myocardial infarction. After treatment of all flow-limiting coronary lesions, three-vessel imaging was done with a combined NIRS and intravascular ultrasound catheter. Untreated lesions (also known as non-culprit lesions) were identified by intravascular ultrasound and their lipid content was assessed by NIRS. The primary outcome was the covariate-adjusted rate of MACEs (the composite of cardiac death, myocardial infarction, unstable angina, or progressive angina) arising from untreated non-culprit lesions during follow-up. The relations between plaques with high lipid content, large plaque burden, and small lumen areas and patient-level and lesion-level events were determined. This trial is registered with ClinicalTrials.gov, NCT02171065. Findings: Between June 10, 2014, and Dec 20, 2017, 3629 non-culprit lesions were characterised in 898 patients (153 [17%] women, 745 [83%] men; median age 63 [IQR 55-70] years). Median follow-up was 3.7 (IQR 3.0-4.4) years. Adverse events within 4 years occurred in 112 (13.2%, 95% CI 11.0-15.6) of 898 patients, with 66 (8.0%, 95% CI 6.2-10.0) arising from 78 untreated non-culprit lesions (mean baseline angiographic diameter stenosis 46.9% [SD 15.9]). Highly lipidic lesions (851 [24%] of 3500 lesions, present in 520 [59%] of 884 patients) were an independent predictor of patient-level non-culprit lesion-related MACEs (adj

Details

Database :
OAIster
Notes :
English
Publication Type :
Electronic Resource
Accession number :
edsoai.on1280659965
Document Type :
Electronic Resource
Full Text :
https://doi.org/10.1016.S0140-6736(21)00249-X