Vol 27, No 3 (2020)
Original articles — Interventional cardiology
Published online: 2018-09-20

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Coronary plaque redistribution after stent implantation is determined by lipid composition: A NIRS-IVUS analysis

Tomasz Roleder1, Magdalena Dobrolinska2, Elzbieta Pociask3, Wojciech Wanha2, Grzegorz Smolka2, Wojciech Walkowicz1, Radoslaw Parma2, Mariusz Lebek1, Tomasz Bochenek4, Przemysław Pietraszewski5, Elvin Kedhi6, Andrzej Ochala2, Zbigniew Gasior1, Ziad A. Ali78, Wojciech Wojakowski2
Pubmed: 30246238
Cardiol J 2020;27(3):238-245.

Abstract

Background: The composition of plaque impacts the results of stenting. The following study evaluated plaque redistribution related to stent implantation using combined near-infrared spectroscopy and intravascular ultrasound (NIRS-IVUS) imaging.

Methods: The present study included 49 patients (mean age 66 ± 11 years, 75% males) presenting with non-ST elevation myocardial infarction (8%), unstable angina (49%) and stable coronary artery disease (43%). The following parameters were analyzed: mean plaque volume (MPV, mm3), plaque burden (PB, %), remodeling index (RI), and maximal lipid core burden index in a 4 mm segment (maxLCBI4mm). High-lipid burden lesions (HLB) were defined as by maxLCBI4mm > 265 with positive RI. Otherwise plaques were defined as low-lipid burden lesions (LLB). Measurements were done in the target lesion and in 4 mm edges of the stent before and after stent implantation.

Results: MPV and maxLCBI4mm decreased in both HLB (MPV 144.70 [80.47, 274.25] vs. 97.60 [56.82, 223.45]; maxLCBI4mm: 564.11 ± 166.82 vs. 258.11 ± 234.24, p = 0.004) and LLB (MPV: 124.50 [68.00, 186.20] vs. 101.10 [67.87, 165.95]; maxLCBI4mm: 339.07 ± 268.22 vs. 124.60 ± 160.96, p < 0.001), but MPV decrease was greater in HLB (28.00 [22.60, 57.10] vs. 13.50 [1.50, 28.84], p = 0.019). Only at the proximal stent edge of LLB, maxLCBI4mm decreased (34 [0, 207] vs. 0 [0, 45], p = 0.049) and plaque burden increased (45.48 [40.34, 51.55] vs. 51.75 [47.48, 55.76], p = 0.030).

Conclusions: NIRS-IVUS defined HLB characterized more significant decreases in plaque volume by stenting. Plaque redistribution to the proximal edge of the implanted stent occurred only in LLB.

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