Impact of Lipidic Plaque on In-Stent and Stent Edge-Related Events After PCI in Myocardial Infarction: A PROSPECT II Substudy

Lars Kjøller-Hansen; Akiko Maehara; Henning Kelbæk; Mitsuaki Matsumura; Michael Maeng; Thomas Engstrøm; Ole Fröbert; Jonas Persson; Rune Wiseth; Alf Inge Larsen; Lisette Okkels Jensen; Jan Erik Nordrehaug; Elmir Omerovic; Claes Held; Stefan James; Gary S Mintz; Ziad A Ali; Gregg W Stone; David Erlinge

doi:10.1161/CIRCINTERVENTIONS.124.014215

Impact of Lipidic Plaque on In-Stent and Stent Edge-Related Events After PCI in Myocardial Infarction: A PROSPECT II Substudy

Lars Kjøller-Hansen, Akiko Maehara, Henning Kelbæk, Mitsuaki Matsumura, Michael Maeng, Thomas Engstrøm, Ole Fröbert, Jonas Persson, Rune Wiseth, Alf Inge Larsen, Lisette Okkels Jensen, Jan Erik Nordrehaug, Elmir Omerovic, Claes Held, Stefan James, Gary S Mintz, Ziad A Ali, Gregg W Stone, David Erlinge

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

BACKGROUND: Lipid content in untreated nonobstructive coronary artery lesions is associated with adverse clinical outcomes, and residual in-stent or stent edge lipid may worsen outcomes after percutaneous coronary intervention (PCI). METHODS: Near-infrared spectroscopy-intravascular ultrasound was performed before and after PCI in patients with myocardial infarction. We evaluated the impact of lipid assessed by near-infrared spectroscopy (maximal lipid core burden index over 4 mm [maxLCBI_4mm]) along with intravascular ultrasound information including residual plaque burden on in-stent or edge-related major adverse cardiac events (MACE) in de novo PCI-treated culprit coronary artery lesions. The primary end point was culprit lesion-related MACE (CL-MACE), defined as cardiac death, myocardial infarction, or unstable or progressive angina either requiring revascularization or with rapid lesion progression and classified as in-stent or stent edge-related. RESULTS: During a median follow-up of 3.8 years, 25 CL-MACE (11 stent edge-related, 13 in-stent, and 1 in-lesion without a stent) occurred in 1041 PCI-treated lesions in 768 patients. Pre-PCI or post-PCI measures of lipid content were not related to in-stent CL-MACE. However, stent edge-related CL-MACE was increased if both the post-PCI stent edge maxLCBI_4mm was greater than the upper quartile (108.7) and the stent edge plaque burden was >50% (adjusted odds ratio, 4.11 [95% CI, 1.12-15.2]; P=0.03). CONCLUSIONS: In PROSPECT II (Providing Regional Observations to Study Predictors of Events in the Coronary Tree), CL stent implantation leaving behind greater stent edge-related lipid and uncovered plaque burden was associated with an increased risk of stent edge-related CL-MACE during follow-up. In contrast, CL lipid content was not related to in-stent CL-MACE.

Original language	English
Journal	Circulation. Cardiovascular Interventions
Volume	17
Issue	10
Pages (from-to)	e014215
ISSN	1941-7640
DOIs	https://doi.org/10.1161/CIRCINTERVENTIONS.124.014215
Publication status	Published - Oct 2024

Keywords

coronary vessels
follow-up studies
lipids
near-infrared
percutaneous coronary intervention
spectroscopy

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10.1161/CIRCINTERVENTIONS.124.014215

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Kjøller-Hansen, L., Maehara, A., Kelbæk, H., Matsumura, M., Maeng, M., Engstrøm, T., Fröbert, O., Persson, J., Wiseth, R., Larsen, A. I., Jensen, L. O., Nordrehaug, J. E., Omerovic, E., Held, C., James, S., Mintz, G. S., Ali, Z. A., Stone, G. W., & Erlinge, D. (2024). Impact of Lipidic Plaque on In-Stent and Stent Edge-Related Events After PCI in Myocardial Infarction: A PROSPECT II Substudy. Circulation. Cardiovascular Interventions, 17(10), e014215. https://doi.org/10.1161/CIRCINTERVENTIONS.124.014215

@article{df49b26993bf45539dfec9916a90d0f8,

title = "Impact of Lipidic Plaque on In-Stent and Stent Edge-Related Events After PCI in Myocardial Infarction: A PROSPECT II Substudy",

abstract = "BACKGROUND: Lipid content in untreated nonobstructive coronary artery lesions is associated with adverse clinical outcomes, and residual in-stent or stent edge lipid may worsen outcomes after percutaneous coronary intervention (PCI). METHODS: Near-infrared spectroscopy-intravascular ultrasound was performed before and after PCI in patients with myocardial infarction. We evaluated the impact of lipid assessed by near-infrared spectroscopy (maximal lipid core burden index over 4 mm [maxLCBI4mm]) along with intravascular ultrasound information including residual plaque burden on in-stent or edge-related major adverse cardiac events (MACE) in de novo PCI-treated culprit coronary artery lesions. The primary end point was culprit lesion-related MACE (CL-MACE), defined as cardiac death, myocardial infarction, or unstable or progressive angina either requiring revascularization or with rapid lesion progression and classified as in-stent or stent edge-related. RESULTS: During a median follow-up of 3.8 years, 25 CL-MACE (11 stent edge-related, 13 in-stent, and 1 in-lesion without a stent) occurred in 1041 PCI-treated lesions in 768 patients. Pre-PCI or post-PCI measures of lipid content were not related to in-stent CL-MACE. However, stent edge-related CL-MACE was increased if both the post-PCI stent edge maxLCBI4mm was greater than the upper quartile (108.7) and the stent edge plaque burden was >50% (adjusted odds ratio, 4.11 [95% CI, 1.12-15.2]; P=0.03). CONCLUSIONS: In PROSPECT II (Providing Regional Observations to Study Predictors of Events in the Coronary Tree), CL stent implantation leaving behind greater stent edge-related lipid and uncovered plaque burden was associated with an increased risk of stent edge-related CL-MACE during follow-up. In contrast, CL lipid content was not related to in-stent CL-MACE.",

keywords = "coronary vessels, follow-up studies, lipids, near-infrared, percutaneous coronary intervention, spectroscopy",

author = "Lars Kj{\o}ller-Hansen and Akiko Maehara and Henning Kelb{\ae}k and Mitsuaki Matsumura and Michael Maeng and Thomas Engstr{\o}m and Ole Fr{\"o}bert and Jonas Persson and Rune Wiseth and Larsen, {Alf Inge} and Jensen, {Lisette Okkels} and Nordrehaug, {Jan Erik} and Elmir Omerovic and Claes Held and Stefan James and Mintz, {Gary S} and Ali, {Ziad A} and Stone, {Gregg W} and David Erlinge",

year = "2024",

month = oct,

doi = "10.1161/CIRCINTERVENTIONS.124.014215",

language = "English",

volume = "17",

pages = "e014215",

journal = "Circulation. Cardiovascular Interventions",

issn = "1941-7640",

publisher = "LIPPINCOTT WILLIAMS & WILKINS",

number = "10",

}

Kjøller-Hansen, L, Maehara, A, Kelbæk, H, Matsumura, M, Maeng, M, Engstrøm, T, Fröbert, O, Persson, J, Wiseth, R, Larsen, AI, Jensen, LO, Nordrehaug, JE, Omerovic, E, Held, C, James, S, Mintz, GS, Ali, ZA, Stone, GW & Erlinge, D 2024, 'Impact of Lipidic Plaque on In-Stent and Stent Edge-Related Events After PCI in Myocardial Infarction: A PROSPECT II Substudy', Circulation. Cardiovascular Interventions, vol. 17, no. 10, pp. e014215. https://doi.org/10.1161/CIRCINTERVENTIONS.124.014215

Impact of Lipidic Plaque on In-Stent and Stent Edge-Related Events After PCI in Myocardial Infarction: A PROSPECT II Substudy. / Kjøller-Hansen, Lars; Maehara, Akiko; Kelbæk, Henning et al.
In: Circulation. Cardiovascular Interventions, Vol. 17, No. 10, 10.2024, p. e014215.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Impact of Lipidic Plaque on In-Stent and Stent Edge-Related Events After PCI in Myocardial Infarction

T2 - A PROSPECT II Substudy

AU - Kjøller-Hansen, Lars

AU - Maehara, Akiko

AU - Kelbæk, Henning

AU - Matsumura, Mitsuaki

AU - Maeng, Michael

AU - Engstrøm, Thomas

AU - Fröbert, Ole

AU - Persson, Jonas

AU - Wiseth, Rune

AU - Larsen, Alf Inge

AU - Jensen, Lisette Okkels

AU - Nordrehaug, Jan Erik

AU - Omerovic, Elmir

AU - Held, Claes

AU - James, Stefan

AU - Mintz, Gary S

AU - Ali, Ziad A

AU - Stone, Gregg W

AU - Erlinge, David

PY - 2024/10

Y1 - 2024/10

N2 - BACKGROUND: Lipid content in untreated nonobstructive coronary artery lesions is associated with adverse clinical outcomes, and residual in-stent or stent edge lipid may worsen outcomes after percutaneous coronary intervention (PCI). METHODS: Near-infrared spectroscopy-intravascular ultrasound was performed before and after PCI in patients with myocardial infarction. We evaluated the impact of lipid assessed by near-infrared spectroscopy (maximal lipid core burden index over 4 mm [maxLCBI4mm]) along with intravascular ultrasound information including residual plaque burden on in-stent or edge-related major adverse cardiac events (MACE) in de novo PCI-treated culprit coronary artery lesions. The primary end point was culprit lesion-related MACE (CL-MACE), defined as cardiac death, myocardial infarction, or unstable or progressive angina either requiring revascularization or with rapid lesion progression and classified as in-stent or stent edge-related. RESULTS: During a median follow-up of 3.8 years, 25 CL-MACE (11 stent edge-related, 13 in-stent, and 1 in-lesion without a stent) occurred in 1041 PCI-treated lesions in 768 patients. Pre-PCI or post-PCI measures of lipid content were not related to in-stent CL-MACE. However, stent edge-related CL-MACE was increased if both the post-PCI stent edge maxLCBI4mm was greater than the upper quartile (108.7) and the stent edge plaque burden was >50% (adjusted odds ratio, 4.11 [95% CI, 1.12-15.2]; P=0.03). CONCLUSIONS: In PROSPECT II (Providing Regional Observations to Study Predictors of Events in the Coronary Tree), CL stent implantation leaving behind greater stent edge-related lipid and uncovered plaque burden was associated with an increased risk of stent edge-related CL-MACE during follow-up. In contrast, CL lipid content was not related to in-stent CL-MACE.

AB - BACKGROUND: Lipid content in untreated nonobstructive coronary artery lesions is associated with adverse clinical outcomes, and residual in-stent or stent edge lipid may worsen outcomes after percutaneous coronary intervention (PCI). METHODS: Near-infrared spectroscopy-intravascular ultrasound was performed before and after PCI in patients with myocardial infarction. We evaluated the impact of lipid assessed by near-infrared spectroscopy (maximal lipid core burden index over 4 mm [maxLCBI4mm]) along with intravascular ultrasound information including residual plaque burden on in-stent or edge-related major adverse cardiac events (MACE) in de novo PCI-treated culprit coronary artery lesions. The primary end point was culprit lesion-related MACE (CL-MACE), defined as cardiac death, myocardial infarction, or unstable or progressive angina either requiring revascularization or with rapid lesion progression and classified as in-stent or stent edge-related. RESULTS: During a median follow-up of 3.8 years, 25 CL-MACE (11 stent edge-related, 13 in-stent, and 1 in-lesion without a stent) occurred in 1041 PCI-treated lesions in 768 patients. Pre-PCI or post-PCI measures of lipid content were not related to in-stent CL-MACE. However, stent edge-related CL-MACE was increased if both the post-PCI stent edge maxLCBI4mm was greater than the upper quartile (108.7) and the stent edge plaque burden was >50% (adjusted odds ratio, 4.11 [95% CI, 1.12-15.2]; P=0.03). CONCLUSIONS: In PROSPECT II (Providing Regional Observations to Study Predictors of Events in the Coronary Tree), CL stent implantation leaving behind greater stent edge-related lipid and uncovered plaque burden was associated with an increased risk of stent edge-related CL-MACE during follow-up. In contrast, CL lipid content was not related to in-stent CL-MACE.

KW - coronary vessels

KW - follow-up studies

KW - lipids

KW - near-infrared

KW - percutaneous coronary intervention

KW - spectroscopy

UR - http://www.scopus.com/inward/record.url?scp=85205430246&partnerID=8YFLogxK

U2 - 10.1161/CIRCINTERVENTIONS.124.014215

DO - 10.1161/CIRCINTERVENTIONS.124.014215

M3 - Journal article

C2 - 39319453

SN - 1941-7640

VL - 17

SP - e014215

JO - Circulation. Cardiovascular Interventions

JF - Circulation. Cardiovascular Interventions

IS - 10

ER -

Impact of Lipidic Plaque on In-Stent and Stent Edge-Related Events After PCI in Myocardial Infarction: A PROSPECT II Substudy

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