title: The relationship among extent of lipid-rich plaque, lesion characteristics, and plaque progression/regression in patients with coronary artery disease: a serial near-infrared spectroscopy and intravascular ultrasound study.
abstract: OBJECTIVE
  To evaluate the relationship between lipid content and plaque morphometry as well as the process of lesion progression and regression in patients with significant coronary artery disease.
  
  
  RESULTS
  The present study, using data from the YELLOW trial, was conducted in patients having significant coronary lesions (fractional flow reserve <0.8) who underwent serial intravascular ultrasound (IVUS) and near-infrared spectroscopy (NIRS) at baseline and after 7 weeks. For each coronary plaque (≥50% plaque burden that was ≥5 mm in length), we evaluated plaque characteristics and the extent of lipid-rich plaque [LRP, defined as the 4 mm long segment with the maximum lipid-core burden index (maxLCBI4 mm)] on NIRS. Among 66 patients (age 63.0 ± 10.1 years; 82% statin use at baseline), 94 plaques were identified. The extent of LRP at baseline was positively correlated with IVUS plaque burden (r = 0.317, P = 0.002). A large LRP (maxLCBI4 mm ≥500) was present only in plaques with a large plaque burden (≥70%). Multivariate analysis demonstrated that plaque burden was the best predictor of the extent of LRP (P < 0.001). In lesions with a large plaque burden and a large amount of LRP at baseline, a reduction in LRP was seen in all lesions in patients receiving intensive statin therapy (P = 0.004) without a significant change in plaque burden.
  
  
  CONCLUSIONS
  Coronary lesions containing a large amount of LRP also had a large plaque burden. Short-term regression of LRP (without a change in plaque burden) was observed mainly in plaques with a large plaque burden and a large amount of LRP at baseline.
  
  
  BACKGROUND
  http://www.clinicaltrials.gov. Unique identifier: NCT01567826.
authors.affiliation: Columbia University Medical Center, New York, NY, USA Cardiovascular Research Foundation, 111 East 59th Street, 12th Floor, New York, NY 10022, USA.
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Dohi
authors.affiliation: Columbia University Medical Center, New York, NY, USA Cardiovascular Research Foundation, 111 East 59th Street, 12th Floor, New York, NY 10022, USA amaehara@crf.org.
authors.forename: Akiko
authors.initials: A
authors.lastname: Maehara
authors.affiliation: The Zena and Michael A. Weiner Cardiovascular Institute and the Marie-Josée and Henry R. Kravis Cardiovascular Health Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Pedro R
authors.initials: PR
authors.lastname: Moreno
authors.affiliation: The Zena and Michael A. Weiner Cardiovascular Institute and the Marie-Josée and Henry R. Kravis Cardiovascular Health Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Usman
authors.initials: U
authors.lastname: Baber
authors.affiliation: The Zena and Michael A. Weiner Cardiovascular Institute and the Marie-Josée and Henry R. Kravis Cardiovascular Health Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Jason C
authors.initials: JC
authors.lastname: Kovacic
authors.affiliation: The Zena and Michael A. Weiner Cardiovascular Institute and the Marie-Josée and Henry R. Kravis Cardiovascular Health Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Atul M
authors.initials: AM
authors.lastname: Limaye
authors.affiliation: Columbia University Medical Center, New York, NY, USA The Zena and Michael A. Weiner Cardiovascular Institute and the Marie-Josée and Henry R. Kravis Cardiovascular Health Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Ziad A
authors.initials: ZA
authors.lastname: Ali
authors.affiliation: The Zena and Michael A. Weiner Cardiovascular Institute and the Marie-Josée and Henry R. Kravis Cardiovascular Health Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Sweeny
authors.affiliation: Cardiovascular Research Foundation, 111 East 59th Street, 12th Floor, New York, NY 10022, USA The Zena and Michael A. Weiner Cardiovascular Institute and the Marie-Josée and Henry R. Kravis Cardiovascular Health Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Roxana
authors.initials: R
authors.lastname: Mehran
authors.affiliation: Cardiovascular Research Foundation, 111 East 59th Street, 12th Floor, New York, NY 10022, USA The Zena and Michael A. Weiner Cardiovascular Institute and the Marie-Josée and Henry R. Kravis Cardiovascular Health Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: George D
authors.initials: GD
authors.lastname: Dangas
authors.affiliation: Cardiovascular Research Foundation, 111 East 59th Street, 12th Floor, New York, NY 10022, USA.
authors.forename: Ke
authors.initials: K
authors.lastname: Xu
authors.affiliation: The Zena and Michael A. Weiner Cardiovascular Institute and the Marie-Josée and Henry R. Kravis Cardiovascular Health Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Samin K
authors.initials: SK
authors.lastname: Sharma
authors.affiliation: Cardiovascular Research Foundation, 111 East 59th Street, 12th Floor, New York, NY 10022, USA.
authors.forename: Gary S
authors.initials: GS
authors.lastname: Mintz
authors.affiliation: The Zena and Michael A. Weiner Cardiovascular Institute and the Marie-Josée and Henry R. Kravis Cardiovascular Health Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Annapoorna S
authors.initials: AS
authors.lastname: Kini
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods; D000924:Anticholesteremic Agents / Q000008:administration & dosage*; D016001:Confidence Intervals; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D050356:Lipid Metabolism / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012008:Recurrence; D018570:Risk Assessment; D012720:Severity of Illness Index; D016037:Single-Blind Method; D019265:Spectroscopy, Near-Infrared / Q000379:methods*; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*
chemical_list: D000924:Anticholesteremic Agents
keywords: Intravascular ultrasound; Lipid-rich plaque; Near-infrared spectroscopy; Plaque regression