Relationship Between Optical Coherence Tomography–Derived In‐Stent Neoatherosclerosis and the Extent of Lipid‐Rich Neointima by Near‐Infrared Spectroscopy and Intravascular Ultrasound: A Multimodal Imaging Study

Background In‐stent restenosis, especially for neoatherosclerosis, is a major concern following percutaneous coronary intervention. This study aimed to elucidate the association of features of in‐stent restenosis lesions revealed by optical coherence tomography (OCT)/optical frequency domain imaging...

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Main Authors: Mitsuhiro Takeuchi, Tomotaka Dohi, Mitsuaki Matsumura, Tatsuya Fukase, Ryota Nishio, Norihito Takahashi, Hirohisa Endo, Hiroki Nishiyama, Shinichiro Doi, Iwao Okai, Hiroshi Iwata, Shinya Okazaki, Katsumi Miyauchi, Hiroyuki Daida, Tohru Minamino
Format: Article
Language:English
Published: Wiley 2022-12-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Subjects:
Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.122.026569
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author Mitsuhiro Takeuchi
Tomotaka Dohi
Mitsuaki Matsumura
Tatsuya Fukase
Ryota Nishio
Norihito Takahashi
Hirohisa Endo
Hiroki Nishiyama
Shinichiro Doi
Iwao Okai
Hiroshi Iwata
Shinya Okazaki
Katsumi Miyauchi
Hiroyuki Daida
Tohru Minamino
author_facet Mitsuhiro Takeuchi
Tomotaka Dohi
Mitsuaki Matsumura
Tatsuya Fukase
Ryota Nishio
Norihito Takahashi
Hirohisa Endo
Hiroki Nishiyama
Shinichiro Doi
Iwao Okai
Hiroshi Iwata
Shinya Okazaki
Katsumi Miyauchi
Hiroyuki Daida
Tohru Minamino
author_sort Mitsuhiro Takeuchi
collection DOAJ
description Background In‐stent restenosis, especially for neoatherosclerosis, is a major concern following percutaneous coronary intervention. This study aimed to elucidate the association of features of in‐stent restenosis lesions revealed by optical coherence tomography (OCT)/optical frequency domain imaging (OFDI) and the extent of lipid‐rich neointima (LRN) assessed by near‐infrared spectroscopy (NIRS) and intravascular ultrasound, especially for neoatherosclerosis. Methods and Results We analyzed patients undergoing percutaneous coronary intervention for in‐stent restenosis lesions using both OCT/OFDI and NIRS–intravascular ultrasound. OCT/OFDI‐derived neoatherosclerosis was defined as lipid neointima. The existence of large LRN (defined as a long segment with 4‐mm maximum lipid core burden index ≥400) was evaluated by NIRS. In 59 patients with 64 lesions, neoatherosclerosis and large LRN were observed in 17 (26.6%) and 21 lesions (32.8%), respectively. Naturally, large LRN showed higher 4‐mm maximum lipid core burden index (median [interquartile range], 623 [518–805] versus 176 [0–524]; P<0.001). In OCT/OFDI findings, large LRN displayed lower minimal lumen area (0.9±0.4 versus 1.3±0.6 mm2; P=0.02) and greater max lipid arc (median [interquartile range], 272° [220°–360°] versus 193° [132°–247°]; P=0.004). In the receiver operating characteristic curve analysis, 4‐mm maximum lipid core burden index was the best predictor for neoatherosclerosis, with a cutoff value of 405 (area under curve, 0.92 [95% CI, 0.83–1.00]). In multivariable logistic analysis, only low‐density lipoprotein cholesterol (odds ratio, 1.52 [95% CI, 1.11–2.08]) was an independent predictor for large LRNs. Conclusions NIRS‐derived large LRN was significantly associated with neoatherosclerosis by OCT/OFDI. The neointimal characterization by NIRS–intravascular ultrasound has potential as an alternative method of OCT/OFDI for in‐stent restenosis lesions.
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spelling doaj.art-ba507fbe0901408282e2bdac68a8729a2023-02-07T16:03:22ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802022-12-01112310.1161/JAHA.122.026569Relationship Between Optical Coherence Tomography–Derived In‐Stent Neoatherosclerosis and the Extent of Lipid‐Rich Neointima by Near‐Infrared Spectroscopy and Intravascular Ultrasound: A Multimodal Imaging StudyMitsuhiro Takeuchi0Tomotaka Dohi1Mitsuaki Matsumura2Tatsuya Fukase3Ryota Nishio4Norihito Takahashi5Hirohisa Endo6Hiroki Nishiyama7Shinichiro Doi8Iwao Okai9Hiroshi Iwata10Shinya Okazaki11Katsumi Miyauchi12Hiroyuki Daida13Tohru Minamino14Department of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanBackground In‐stent restenosis, especially for neoatherosclerosis, is a major concern following percutaneous coronary intervention. This study aimed to elucidate the association of features of in‐stent restenosis lesions revealed by optical coherence tomography (OCT)/optical frequency domain imaging (OFDI) and the extent of lipid‐rich neointima (LRN) assessed by near‐infrared spectroscopy (NIRS) and intravascular ultrasound, especially for neoatherosclerosis. Methods and Results We analyzed patients undergoing percutaneous coronary intervention for in‐stent restenosis lesions using both OCT/OFDI and NIRS–intravascular ultrasound. OCT/OFDI‐derived neoatherosclerosis was defined as lipid neointima. The existence of large LRN (defined as a long segment with 4‐mm maximum lipid core burden index ≥400) was evaluated by NIRS. In 59 patients with 64 lesions, neoatherosclerosis and large LRN were observed in 17 (26.6%) and 21 lesions (32.8%), respectively. Naturally, large LRN showed higher 4‐mm maximum lipid core burden index (median [interquartile range], 623 [518–805] versus 176 [0–524]; P<0.001). In OCT/OFDI findings, large LRN displayed lower minimal lumen area (0.9±0.4 versus 1.3±0.6 mm2; P=0.02) and greater max lipid arc (median [interquartile range], 272° [220°–360°] versus 193° [132°–247°]; P=0.004). In the receiver operating characteristic curve analysis, 4‐mm maximum lipid core burden index was the best predictor for neoatherosclerosis, with a cutoff value of 405 (area under curve, 0.92 [95% CI, 0.83–1.00]). In multivariable logistic analysis, only low‐density lipoprotein cholesterol (odds ratio, 1.52 [95% CI, 1.11–2.08]) was an independent predictor for large LRNs. Conclusions NIRS‐derived large LRN was significantly associated with neoatherosclerosis by OCT/OFDI. The neointimal characterization by NIRS–intravascular ultrasound has potential as an alternative method of OCT/OFDI for in‐stent restenosis lesions.https://www.ahajournals.org/doi/10.1161/JAHA.122.026569in‐stent restenosisnear‐infrared spectroscopyneoatherosclerosisoptical coherence tomographyoptical frequency domain imaging
spellingShingle Mitsuhiro Takeuchi
Tomotaka Dohi
Mitsuaki Matsumura
Tatsuya Fukase
Ryota Nishio
Norihito Takahashi
Hirohisa Endo
Hiroki Nishiyama
Shinichiro Doi
Iwao Okai
Hiroshi Iwata
Shinya Okazaki
Katsumi Miyauchi
Hiroyuki Daida
Tohru Minamino
Relationship Between Optical Coherence Tomography–Derived In‐Stent Neoatherosclerosis and the Extent of Lipid‐Rich Neointima by Near‐Infrared Spectroscopy and Intravascular Ultrasound: A Multimodal Imaging Study
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
in‐stent restenosis
near‐infrared spectroscopy
neoatherosclerosis
optical coherence tomography
optical frequency domain imaging
title Relationship Between Optical Coherence Tomography–Derived In‐Stent Neoatherosclerosis and the Extent of Lipid‐Rich Neointima by Near‐Infrared Spectroscopy and Intravascular Ultrasound: A Multimodal Imaging Study
title_full Relationship Between Optical Coherence Tomography–Derived In‐Stent Neoatherosclerosis and the Extent of Lipid‐Rich Neointima by Near‐Infrared Spectroscopy and Intravascular Ultrasound: A Multimodal Imaging Study
title_fullStr Relationship Between Optical Coherence Tomography–Derived In‐Stent Neoatherosclerosis and the Extent of Lipid‐Rich Neointima by Near‐Infrared Spectroscopy and Intravascular Ultrasound: A Multimodal Imaging Study
title_full_unstemmed Relationship Between Optical Coherence Tomography–Derived In‐Stent Neoatherosclerosis and the Extent of Lipid‐Rich Neointima by Near‐Infrared Spectroscopy and Intravascular Ultrasound: A Multimodal Imaging Study
title_short Relationship Between Optical Coherence Tomography–Derived In‐Stent Neoatherosclerosis and the Extent of Lipid‐Rich Neointima by Near‐Infrared Spectroscopy and Intravascular Ultrasound: A Multimodal Imaging Study
title_sort relationship between optical coherence tomography derived in stent neoatherosclerosis and the extent of lipid rich neointima by near infrared spectroscopy and intravascular ultrasound a multimodal imaging study
topic in‐stent restenosis
near‐infrared spectroscopy
neoatherosclerosis
optical coherence tomography
optical frequency domain imaging
url https://www.ahajournals.org/doi/10.1161/JAHA.122.026569
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