Aims The aim of this study was to assess the morphological characteristics and prognostic implications of the optical coherence tomography (OCT)-derived lipid core burden index (LCBI). Methods and results OCT-LCBI was assessed in 1003 patients with 1-year follow-up from the CLIMA multicentre registry using a validated software able to automatically obtain a maximum OCT-LCBI in 4 mm (maxOCT-LCBI4mm). Primary composite clinical endpoint included cardiac death, myocardial infarction, and target-vessel revascularization. A secondary analysis using clinical outcomes of CLIMA study was performed. Patients with a maxOCT-LCBI4mm >= 400 showed higher prevalence of fibrous cap thickness (FCT) <75 mu m [odds ratio (OR) 1.43, 95% confidence interval (CI) 1.03-1.99; P = 0.034], lipid pool arc >180 degrees (OR 3.93, 95%CI 2.97-5.21; P < 0.001), minimum lumen area <3.5 mm(2) (OR 1.5, 95%CI 1.16-1.94; P = 0.002), macrophage infiltration (OR 2.38, 95%CI 1.81-3.13; P < 0.001), and intra-plaque intimal vasculature (OR 1.34, 95%CI 1.05-1.72; P = 0.021). A maxOCT-LCBI4mm >= 400 predicted the primary endpoint [adjusted hazard ratio (HR) 1.86, 95%CI 1.1-3.2; P = 0.019] as well as the CLIMA endpoint (HR 2.56, 95%CI 1.24-5.29; P = 0.011). Patients with high lipid content and thin FCT < 75 mu m were at higher risk for adverse events (HR 4.88, 95%CI 2.44-9.72; P < 0.001). Conclusions A high maxOCT-LCBI4mm was related to poor outcome and vulnerable plaque features. This study represents a step further in the automated assessment of the coronary plaque risk profile.

Optical coherence tomography-derived lipid core burden index and clinical outcomes. results from the CLIMA registry / Biccire, Fg; Budassi, S; Ozaki, Y; Boi, A; Romagnoli, E; Di Pietro, R; Bourantas, Cv; Marco, V; Paoletti, G; Debelak, C; Sammartini, E; Versaci, F; Fabbiocchi, F; Burzotta, F; Pastori, D; Crea, F; Arbustini, E; Alfonso, F; Prati, F. - In: EUROPEAN HEART JOURNAL. CARDIOVASCULAR IMAGING. - ISSN 2047-2404. - 24:4(2023), pp. 437-445. [10.1093/ehjci/jeac110]

Optical coherence tomography-derived lipid core burden index and clinical outcomes. results from the CLIMA registry

Pastori, D;
2023

Abstract

Aims The aim of this study was to assess the morphological characteristics and prognostic implications of the optical coherence tomography (OCT)-derived lipid core burden index (LCBI). Methods and results OCT-LCBI was assessed in 1003 patients with 1-year follow-up from the CLIMA multicentre registry using a validated software able to automatically obtain a maximum OCT-LCBI in 4 mm (maxOCT-LCBI4mm). Primary composite clinical endpoint included cardiac death, myocardial infarction, and target-vessel revascularization. A secondary analysis using clinical outcomes of CLIMA study was performed. Patients with a maxOCT-LCBI4mm >= 400 showed higher prevalence of fibrous cap thickness (FCT) <75 mu m [odds ratio (OR) 1.43, 95% confidence interval (CI) 1.03-1.99; P = 0.034], lipid pool arc >180 degrees (OR 3.93, 95%CI 2.97-5.21; P < 0.001), minimum lumen area <3.5 mm(2) (OR 1.5, 95%CI 1.16-1.94; P = 0.002), macrophage infiltration (OR 2.38, 95%CI 1.81-3.13; P < 0.001), and intra-plaque intimal vasculature (OR 1.34, 95%CI 1.05-1.72; P = 0.021). A maxOCT-LCBI4mm >= 400 predicted the primary endpoint [adjusted hazard ratio (HR) 1.86, 95%CI 1.1-3.2; P = 0.019] as well as the CLIMA endpoint (HR 2.56, 95%CI 1.24-5.29; P = 0.011). Patients with high lipid content and thin FCT < 75 mu m were at higher risk for adverse events (HR 4.88, 95%CI 2.44-9.72; P < 0.001). Conclusions A high maxOCT-LCBI4mm was related to poor outcome and vulnerable plaque features. This study represents a step further in the automated assessment of the coronary plaque risk profile.
2023
optical coherence tomography; lipid core burden index; cardiac events; vulnerable plaque; risk stratification
01 Pubblicazione su rivista::01a Articolo in rivista
Optical coherence tomography-derived lipid core burden index and clinical outcomes. results from the CLIMA registry / Biccire, Fg; Budassi, S; Ozaki, Y; Boi, A; Romagnoli, E; Di Pietro, R; Bourantas, Cv; Marco, V; Paoletti, G; Debelak, C; Sammartini, E; Versaci, F; Fabbiocchi, F; Burzotta, F; Pastori, D; Crea, F; Arbustini, E; Alfonso, F; Prati, F. - In: EUROPEAN HEART JOURNAL. CARDIOVASCULAR IMAGING. - ISSN 2047-2404. - 24:4(2023), pp. 437-445. [10.1093/ehjci/jeac110]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1671250
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