Abstract 20382: Long-Term Follow-Up After NIRS Coronary Imaging: Insights From the ORACLE-NIRS Registry

IntroductionNear-infrared spectroscopy (NIRS)-measured coronary lipid burden may be associated with the incidence of subsequent cardiovascular events. We sought to evaluate long-term outcomes after NIRS imaging.MethodsWe analyzed data from 241 patients participating in the ORACLE-NIRS registry who underwent NIRS coronary imaging during clinically-indicated cardiac catheterization from 2009-2011. NIRS was performed in vessels that did and did not undergo percutaneous coronary intervention (PCI).ResultsMean patient age was 64 ± 9 years, 99% were men and 50% were diabetic, presenting with stable angina (51%) or an acute coronary syndrome (ACS, 49%). Pre-intervention NIRS data from 118 target vessels and 38 non-target vessels in 139 patients was available. Median lipid core burden index (LCBI) of PCI target vessels was 87 [interquartile range, IQR 48-129]. Median LCBI in non-target vessels was 59 [IQR 29-98]. During a median follow-up of 5.7 years the incidence of major adverse cardiovascular events (MACE; cardiac mortality, acute coronary syndromes (ACS), stroke, and unplanned revascularization) was 44.4%. Cardiac mortality or ACS occurred in 30.7%. Target vessel revascularization occurred in 16.9% and non-target revascularization in 12.2%. Cox regression was used to evaluate the association between LCBI and MACE. Median vessel LCBI was used as a threshold for prediction of events, as well as LCBI of 80, as determined by receiver-operating characteristic curve analysis. The age-adjusted hazard ratio (HR) for MACE in target vessels with LCBI ≥80 was 0.93, 95% confidence interval (CI) 0.53-1.67, p=0.82. In non-target vessels, the adjusted HR for MACE with LCBI ≥80 was 4.07, 95%CI 1.13-16.24, p=0.032 (Figure).ConclusionDuring long-term follow-up of patients who underwent NIRS imaging, LCBI ≥80 in a non-target vessel was associated with higher incidence of MACE.