title: Near-infrared spectroscopy predicts cardiovascular outcome in patients with coronary artery disease.
abstract: BACKGROUND
  Near-infrared spectroscopy (NIRS) is capable of identifying lipid core-containing plaques, which can subsequently be quantified as a lipid core burden index (LCBI). Currently, no data are available on the long-term prognostic value of NIRS in patients with coronary artery disease (CAD).
  
  
  OBJECTIVE
  This study sought to determine the long-term prognostic value of intracoronary NIRS as assessed in a nonculprit vessel in patients with CAD.
  
  
  METHODS
  In this prospective, observational study, NIRS imaging was performed in a nonculprit coronary artery in 203 patients referred for angiography due to stable angina pectoris (SAP) or acute coronary syndrome (ACS). The primary endpoint was the composite of all-cause mortality, nonfatal ACS, stroke, and unplanned coronary revascularization.
  
  
  RESULTS
  The 1-year cumulative incidence of the primary endpoint was 10.4%. Cumulative 1-year rates in patients with an LCBI equal to and above the median (43.0) versus those with LCBI values below the median were 16.7% versus 4.0% (adjusted hazard ratio: 4.04; 95% confidence interval: 1.33 to 12.29; p = 0.01). The relation between LCBI and the primary endpoint was similar in SAP and ACS patients (p value for heterogeneity = 0.14). Similar differences between high and low LCBI were observed in pre-specified secondary endpoints.
  
  
  CONCLUSIONS
  CAD patients with an LCBI equal to or above the median of 43.0, as assessed by NIRS in a nonculprit coronary artery, had a 4-fold risk of adverse cardiovascular events during 1-year follow-up. This observation warrants confirmation by larger studies with extended follow-up. (The European Collaborative Project on Inflammation and Vascular Wall Remodeling in Atherosclerosis - Intravascular Ultrasound Study [AtheroRemoIVUS]; NCT01789411).
authors.affiliation: Thoraxcenter, Department of Cardiology, Erasmus Medical Center and Cardiovascular Research Institute COEUR, Rotterdam, the Netherlands; Interuniversity Cardiology Institute of the Netherlands, Utrecht, the Netherlands.
authors.forename: Rohit M
authors.initials: RM
authors.lastname: Oemrawsingh
authors.affiliation: Thoraxcenter, Department of Cardiology, Erasmus Medical Center and Cardiovascular Research Institute COEUR, Rotterdam, the Netherlands.
authors.forename: Jin M
authors.initials: JM
authors.lastname: Cheng
authors.affiliation: Thoraxcenter, Department of Cardiology, Erasmus Medical Center and Cardiovascular Research Institute COEUR, Rotterdam, the Netherlands; Cardialysis BV, Rotterdam, the Netherlands.
authors.forename: Héctor M
authors.initials: HM
authors.lastname: García-García
authors.affiliation: Thoraxcenter, Department of Cardiology, Erasmus Medical Center and Cardiovascular Research Institute COEUR, Rotterdam, the Netherlands.
authors.forename: Robert-Jan
authors.initials: RJ
authors.lastname: van Geuns
authors.affiliation: Thoraxcenter, Department of Cardiology, Erasmus Medical Center and Cardiovascular Research Institute COEUR, Rotterdam, the Netherlands.
authors.forename: Sanneke P M
authors.initials: SP
authors.lastname: de Boer
authors.affiliation: Thoraxcenter, Department of Cardiology, Erasmus Medical Center and Cardiovascular Research Institute COEUR, Rotterdam, the Netherlands.
authors.forename: Cihan
authors.initials: C
authors.lastname: Simsek
authors.affiliation: Thoraxcenter, Department of Cardiology, Erasmus Medical Center and Cardiovascular Research Institute COEUR, Rotterdam, the Netherlands.
authors.forename: Isabella
authors.initials: I
authors.lastname: Kardys
authors.affiliation: Thoraxcenter, Department of Cardiology, Erasmus Medical Center and Cardiovascular Research Institute COEUR, Rotterdam, the Netherlands.
authors.forename: Mattie J
authors.initials: MJ
authors.lastname: Lenzen
authors.affiliation: Thoraxcenter, Department of Cardiology, Erasmus Medical Center and Cardiovascular Research Institute COEUR, Rotterdam, the Netherlands.
authors.forename: Ron T
authors.initials: RT
authors.lastname: van Domburg
authors.affiliation: Thoraxcenter, Department of Cardiology, Erasmus Medical Center and Cardiovascular Research Institute COEUR, Rotterdam, the Netherlands.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Regar
authors.affiliation: Thoraxcenter, Department of Cardiology, Erasmus Medical Center and Cardiovascular Research Institute COEUR, Rotterdam, the Netherlands.
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.affiliation: Thoraxcenter, Department of Cardiology, Erasmus Medical Center and Cardiovascular Research Institute COEUR, Rotterdam, the Netherlands.
authors.forename: K Martijn
authors.initials: KM
authors.lastname: Akkerhuis
authors.affiliation: Thoraxcenter, Department of Cardiology, Erasmus Medical Center and Cardiovascular Research Institute COEUR, Rotterdam, the Netherlands. Electronic address: h.boersma@erasmusmc.nl.
authors.forename: Eric
authors.initials: E
authors.lastname: Boersma
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008055:Lipids; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009204:Myocardial Revascularization / Q000706:statistics & numerical data; D009426:Netherlands / Q000453:epidemiology; D058226:Plaque, Atherosclerotic / Q000473:pathology; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D019265:Spectroscopy, Near-Infrared; D020521:Stroke / Q000453:epidemiology
chemical_list: D008055:Lipids
keywords: atherosclerosis; intracoronary imaging; risk stratification