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Saphenous vein graft near‐infrared spectroscopy imaging insights from the lipid core plaque association with clinical events near‐infrared spectroscopy (ORACLE‐NIRS) registry
Author(s) -
Danek Barbara A.,
Karatasakis Aris,
Alame Aya J.,
NguyenTrong PhuongKhanh J.,
Karacsonyi Judit,
Rangan Bavana,
Roesle Michele,
Atwell Amy,
Resendes Erica,
MartinezParachini Jose Roberto,
Iwnetu Rahel,
Kalsaria Pratik,
Siddiqui Furqan,
Muller James E.,
Banerjee Subhash,
Brilakis Emmanouil
Publication year - 2017
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.26696
Subject(s) - medicine , percutaneous coronary intervention , cardiology , dyslipidemia , diabetes mellitus , myocardial infarction , obesity , endocrinology
Objectives 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 maxLCBI 4 mm was 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 maxLCBI 4 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 maxLCBI 4 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 maxLCBI 4mm was 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.