title: Saphenous vein graft near-infrared spectroscopy imaging insights from the lipid core plaque association with clinical events near-infrared spectroscopy (ORACLE-NIRS) registry.
abstract: OBJECTIVE
  We sought to examine near-infrared spectroscopy (NIRS) imaging findings of aortocoronary saphenous vein grafts (SVGs).
  
  
  BACKGROUND
  SVGs are prone to develop atherosclerosis similar to native coronary arteries. They have received little study using NIRS.
  
  
  METHODS
  We examined the clinical characteristics and imaging findings from 43 patients who underwent NIRS imaging of 45 SVGs at our institution between 2009 and 2016.
  
  
  RESULTS
  The mean patient age was 67 ± 7 years and 98% were men, with high prevalence of diabetes mellitus (56%), hypertension (95%), and dyslipidemia (95%). Mean SVG age was 7 ± 7 years, mean SVG lipid core burden index (LCBI) was 53 ± 60 and mean maxLCBI4 mmwas 194 ± 234. Twelve SVGs (27%) had lipid core plaques (2 yellow blocks on the block chemogram), with a higher prevalence in SVGs older than 5 years (46% vs. 5%, P = 0.002). Older SVG age was associated with higher LCBI (r = 0.480, P < 0.001) and higher maxLCBI4 mm(r = 0.567, P < 0.001). On univariate analysis, greater annual total cholesterol exposure was associated with higher SVG LCBI (r = 0.30, P = 0.042) and annual LDL-cholesterol and triglyceride exposure were associated with higher SVG maxLCBI4 mm(LDL-C: r = 0.41, P = 0.020; triglycerides: r = 0.36, P = 0.043). On multivariate analysis, the only independent predictor of SVG LCBI and maxLCBI4mmwas SVG age. SVG percutaneous coronary intervention was performed in 63% of the patients. An embolic protection device was used in 96% of SVG PCIs. Periprocedural myocardial infarction occurred in one patient.
  
  
  CONCLUSIONS
  Older SVG age and greater lipid exposure are associated with higher SVG lipid burden. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Cardiology Division, VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, Texas.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Danek
authors.affiliation: Cardiology Division, VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, Texas.
authors.forename: Aris
authors.initials: A
authors.lastname: Karatasakis
authors.affiliation: Cardiology Division, VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, Texas.
authors.forename: Aya J
authors.initials: AJ
authors.lastname: Alame
authors.affiliation: Cardiology Division, VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, Texas.
authors.forename: Phuong-Khanh J
authors.initials: PJ
authors.lastname: Nguyen-Trong
authors.affiliation: Cardiology Division, VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, Texas.
authors.forename: Judit
authors.initials: J
authors.lastname: Karacsonyi
authors.affiliation: Cardiology Division, VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, Texas.
authors.forename: Bavana
authors.initials: B
authors.lastname: Rangan
authors.affiliation: Cardiology Division, VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, Texas.
authors.forename: Michele
authors.initials: M
authors.lastname: Roesle
authors.affiliation: Cardiology Division, VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, Texas.
authors.forename: Amy
authors.initials: A
authors.lastname: Atwell
authors.affiliation: Cardiology Division, VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, Texas.
authors.forename: Erica
authors.initials: E
authors.lastname: Resendes
authors.affiliation: Cardiology Division, VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, Texas.
authors.forename: Jose Roberto
authors.initials: JR
authors.lastname: Martinez-Parachini
authors.affiliation: Cardiology Division, VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, Texas.
authors.forename: Rahel
authors.initials: R
authors.lastname: Iwnetu
authors.affiliation: Cardiology Division, VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, Texas.
authors.forename: Pratik
authors.initials: P
authors.lastname: Kalsaria
authors.affiliation: Cardiology Division, VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, Texas.
authors.forename: Furqan
authors.initials: F
authors.lastname: Siddiqui
authors.affiliation: Vulnerable Plaque and Patient Program, Cardiovascular Disease Program, Center for Integration of Medicine and Innovative Technology, Boston, Massachusetts.
authors.forename: James E
authors.initials: JE
authors.lastname: Muller
authors.affiliation: Cardiology Division, VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, Texas.
authors.forename: Subhash
authors.initials: S
authors.lastname: Banerjee
authors.affiliation: Cardiology Division, VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, Texas.
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Brilakis
mesh_terms: D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D006801:Humans; D008055:Lipids / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D012042:Registries; D012307:Risk Factors; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D019265:Spectroscopy, Near-Infrared; D013781:Texas; D016896:Treatment Outcome
chemical_list: D008055:Lipids
keywords: lipids; saphenous vein bypass graft; saphenous vein graft interventions