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Coronary plaque redistribution after stent implantation is determined by lipid composition: A NIRS-IVUS analysis
Affiliations- Department of Cardiology, School of Health Sciences Medical University of Silesia in Katowice, Poland
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia in Katowice, Poland
- Department of Biocybernetics and Biomedical Engineering, AGH University of Science and Technology, Krakow, Poland
- First Division of Cardiology, Medical University of Silesia in Katowice, Poland
- Department of Sports Theory, Jerzy Kukuczka Academy of Physical Education in Katowice, Poland
- Isala Hartcentrum, Zwolle, Netherlands
- Center for Interventional Vascular Therapy, Division of Cardiology, Presbyterian Hospital and Columbia University, New York, United States
- Cardiovascular Research Foundation, New York, United States
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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.
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.
Keywords
plaque redistribution, stenting, intravascular ultrasound, near-infrared spectroscopy, stent edges
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About this articleTitle
Coronary plaque redistribution after stent implantation is determined by lipid composition: A NIRS-IVUS analysis
Journal
Issue
Pages
238-245
Published online
2018-09-20
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1991
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945
DOI
Pubmed
Bibliographic record
Cardiol J 2020;27(3):238-245.
Keywords
plaque redistribution
stenting
intravascular ultrasound
near-infrared spectroscopy
stent edges
Authors
Tomasz Roleder
Magdalena Dobrolinska
Elzbieta Pociask
Wojciech Wanha
Grzegorz Smolka
Wojciech Walkowicz
Radoslaw Parma
Mariusz Lebek
Tomasz Bochenek
Przemysław Pietraszewski
Elvin Kedhi
Andrzej Ochala
Zbigniew Gasior
Ziad A. Ali
Wojciech Wojakowski
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