Association of near-infrared spectroscopy-defined lipid rich plaque with lesion morphology and peri-coronary inflammation on computed tomography angiography.

BACKGROUND AND AIMS

Recent studies have reported that the lipid-rich plaque (LRP) detected by near-infrared spectroscopy (NIRS) and the pericoronary adipose tissue attenuation (PCATA) evaluated by coronary computed tomography angiography (CCTA) are associated with worse outcomes. We sought to investigate the relationship between NIRS-defined LRP and PCATA or the incremental ability of PCATA for the prediction of the presence of NIRS-defined LRP when added to the CCTA-derived morphometric findings.

METHODS

A total of 101 de novo lesions of 101 patients with chronic coronary syndromes (CCS), who underwent pre-procedural CCTA and NIRS during percutaneous coronary intervention (PCI), were retrospectively studied. PCATA was assessed by the crude analysis of the mean CT attenuation value of the culprit vessel. NIRS-defined LRP was defined as a maximum lipid core burden index in 4 mm ≥ 400. Univariate and multivariate logistic regression analyses were performed to determine the predictors of NIRS-defined LRP.

RESULTS

NIRS-defined LRP was observed in 37 patients and median PCATA was -72.71. A significant relationship was observed between LCBI and PCATA (r = 0.24, p = 0.001). PCATA (OR: 4.99; 95% CI: 1.48-16.82; p = 0.010) and CCTA-derived positive remodeling (OR: 12.53; 95% CI: 3.56-44.07; p < 0.001) were independent predictors of NIRS-defined LRP. Net reclassification and integrated discrimination improvement indices were both significantly improved when PCATA was added to the reference model including clinical characteristics and CCTA-derived morphometric findings.

CONCLUSIONS

Comprehensive assessment of CCTA including PCATA may provide reliable information to identify the presence of NIRS-defined LRP potentially leading to future adverse events after PCI.