title: Long-term follow-up after near-infrared spectroscopy coronary imaging: Insights from the lipid cORe plaque association with CLinical events (ORACLE-NIRS) registry.
abstract: BACKGROUND
  Coronary lipid core plaque may be associated with the incidence of subsequent cardiovascular events.
  
  
  METHODS
  We analyzed outcomes of 239 patients who underwent near-infrared spectroscopy (NIRS) coronary imaging between 2009-2011. Multivariable Cox regression was used to identify variables independently associated with the incidence of major adverse cardiovascular events (MACE; cardiac mortality, acute coronary syndromes (ACS), stroke, and unplanned revascularization) during follow-up.
  
  
  RESULTS
  Mean patient age was 64±9years, 99% were men, and 50% were diabetic, presenting with stable coronary artery disease (61%) or an acute coronary syndrome (ACS, 39%). Target vessel pre-stenting median lipid core burden index (LCBI) was 88 [interquartile range, IQR 50-130]. Median LCBI in non-target vessels was 57 [IQR 26-94]. Median follow-up was 5.3years. The 5-year MACE rate was 37.5% (cardiac mortality was 15.0%). On multivariable analysis the following variables were associated with MACE: diabetes mellitus, prior percutaneous coronary intervention performed at index angiography, and non-target vessel LCBI. Non-target vessel LCBI of 77 was determined using receiver-operating characteristic curve analysis to be a threshold for prediction of MACE in our cohort. The adjusted hazard ratio (HR) for non-target vessel LCBI ≥77 was 14.05 (95% confidence interval (CI) 2.47-133.51, p=0.002). The 5-year cumulative incidence of events in the above-threshold group was 58.0% vs. 13.1% in the below-threshold group.
  
  
  CONCLUSIONS
  During long-term follow-up of patients who underwent NIRS imaging, high LCBI in a non-PCI target vessel was associated with increased incidence of MACE.
authors.affiliation: VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, TX.
authors.forename: Barbara Anna
authors.initials: BA
authors.lastname: Danek
authors.affiliation: VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, TX.
authors.forename: Aris
authors.initials: A
authors.lastname: Karatasakis
authors.affiliation: VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, TX.
authors.forename: Judit
authors.initials: J
authors.lastname: Karacsonyi
authors.affiliation: VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, TX.
authors.forename: Aya
authors.initials: A
authors.lastname: Alame
authors.affiliation: VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, TX.
authors.forename: Erica
authors.initials: E
authors.lastname: Resendes
authors.affiliation: VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, TX.
authors.forename: Pratik
authors.initials: P
authors.lastname: Kalsaria
authors.affiliation: VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, TX.
authors.forename: Phuong-Khanh J
authors.initials: PJ
authors.lastname: Nguyen-Trong
authors.affiliation: VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, TX.
authors.forename: Bavana V
authors.initials: BV
authors.lastname: Rangan
authors.affiliation: VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, TX.
authors.forename: Michele
authors.initials: M
authors.lastname: Roesle
authors.affiliation: VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, TX.
authors.forename: Shuaib
authors.initials: S
authors.lastname: Abdullah
authors.affiliation: VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, TX.
authors.forename: Subhash
authors.initials: S
authors.lastname: Banerjee
authors.affiliation: VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, TX; Minneapolis Heart Institute, Minneapolis, MN. Electronic address: esbrilakis@gmail.com.
authors.forename: Emmanouil S
authors.initials: ES
authors.lastname: Brilakis
mesh_terms: D054058:Acute Coronary Syndrome / Q000209:etiology; D000368:Aged; D057791:Cardiac Imaging Techniques; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008055:Lipids / Q000032:analysis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009204:Myocardial Revascularization; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D019265:Spectroscopy, Near-Infrared; D020521:Stroke / Q000209:etiology; D013997:Time Factors
chemical_list: D008055:Lipids
keywords: Coronary artery disease; Intravascular imaging; Near-infrared spectroscopy