Quantitative Validation of the Coronary Angioscopic Yellow Plaque with Lipid Core Burden Index Assessed by Intracoronary Near-Infrared Spectroscopy

• Published in: Journal of Atherosclerosis and Thrombosis 2022/03/01, Vol.29(3), pp.362-369
• Main Authors: Omatsu, Takashi, Sotomi, Yohei, Kobayashi, Tomoaki, Hamanaka, Yuma, Hirata, Akio, Hirayama, Atsushi, Ueda, Yasunori, Sakata, Yasushi, Higuchi, Yoshiharu
• Format: Article
• Language: English
• Subjects: Aged; Angioscopy - methods; Coronary angioscopy; Coronary Artery Disease - diagnosis; Coronary Artery Disease - metabolism; Coronary Vessels - diagnostic imaging; Coronary Vessels - metabolism; Female; Follow-Up Studies; Humans; Lipids - analysis; Male; Near-infrared spectroscopy; Original; Plaque, Atherosclerotic - diagnosis; Plaque, Atherosclerotic - metabolism; Predictive Value of Tests; Prospective Studies; Spectroscopy, Near-Infrared - methods; Ultrasonography, Interventional; Vulnerable plaque
• ISSN: 1340-3478; 1880-3873
• DOI: 10.5551/jat.60566

Aim: We aimed to validate the subjective and qualitative angioscopic findings by the objective and quantitative near-infrared spectroscopic (NIRS) assessment to compensate each other’s drawbacks. Methods: This is a single-center prospective observational study. Patients undergoing a planned follow-up coronary angiography after percutaneous coronary intervention were prospectively enrolled from January 2018 to April 2019. The major three vessels were examined by NIRS-intravascular ultrasound, followed by coronary angioscopic evaluation. Yellow color grade on angioscopy was classified into four grades (0, white; 1, slight yellow; 2, yellow; and 3, intensive yellow) at a location of maximal lipid core burden index over 4 mm [LCBI (4)] on NIRS in each vessel. Results: A total of 95 lesions in 44 patients (72.6±6.7 years, 75% male) were analyzed. LCBI (4) was significantly different among different yellow color grades by coronary angioscopy (ANOVA, p＜0.001). Positive correlation was found between angioscopic yellow color grade and LCBI (4) (beta coefficient 164.8, 95% confidence interval 122.9–206.7; p＜0.001). The best cutoff value of LCBI (4) to predict the presence of yellow plaque (yellow color grade ≥ 2) was 448 (sensitivity 79.3%, specificity 69.7%, C-statistic 0.800, 95% confidence interval 0.713–0.887, p＜0.001). Conclusion: The qualitative angioscopic assessment was objectively validated by the quantitative NIRS evaluation, which would be helpful for the reinterpretation of the existing evidences of both imaging modalities.