JOURNAL ARTICLE

In vivo lipid core plaque modification with percutaneous coronary revascularization: a near-infrared spectroscopy study

Aneel Maini, Larisa Buyantseva, Brijeshwar Maini
Journal of Invasive Cardiology 2013, 25 (6): 293-5
23735355

BACKGROUND: Coronary revascularization is associated with no-reflow phenomenon and elevation of cardiac biomarkers. This may occur due to plaque modification. We used near-infrared spectroscopy (NIRS) to evaluate lipid core plaque (LCP) modification with coronary revascularization and its correlation with periprocedural myocardial infarction.

METHODS: Patients presenting to the cardiac catheterization laboratory who underwent NIRS, NIRS/intravascular ultrasound (IVUS) were reviewed and their lipid core burden index (LCBI) was assessed. Using fuzzy c-means clustering algorithm, the coronary was divided into three zones and the lipid burden was recalculated. Its correlation to postprocedure troponin elevation and outcomes with a mean follow-up of 42 months were studied.

RESULTS: A total of 77 coronaries were evaluated. There was an overall decrease in the LCBI after percutaneous revascularization (P<.0001). Using fuzzy c-means clustering algorithm, there was always a decrease in the lipid burden at the site of the percutaneous revascularization (P<.0001). Postprocedure troponin elevation was only noted in patients with an axial shifting of the LCP. There was no difference in long-term outcomes due to the degree of reduction of lipid burden or its axial.

CONCLUSIONS: Plaque modification may be performed successfully using interventional methods and can be evaluated with NIRS. Axial plaque shifting is an acute prognostic marker for postprocedure myocardial infarction.

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