PCI and NIRS-IVUSĪ target vessel was selected according to the presence of significant stenosis, which was considered accountable for clinical manifestations. Written informed consent was obtained from all the patients. The study was approved by the ethics committee of the Korea University Hospital. The decision to undergo NIRS-IVUS imaging was made at the time of angiography and solely by the operator. NIRS-IVUS imaging was performed at the target vessel before PCI and afterwards under selected clinical settings, including patient stability. In total, 636 consecutive patients-and 636 vessels-were included in the analysis. Patients were excluded from the study population if they (1) could not perform cardiovascular angiography due to severe symptoms of heart failure (2) had an expected life expectancy of within 1 year due to accompanying disease and (3) were women of childbearing age who planned to become pregnant within the study period. For inclusion, patients who underwent PCI after performing target vessel NIRS-IVUS-imaging and who agreed to the study plan and clinical follow-up plan, voluntarily decided to participate in this clinical study, and agreed in providing written consent were enrolled. Patients aged 19 years or older were eligible for enrolment, and the inclusion and exclusion criteria were as follows. Performing PCI for high-LCBI lesions may necessitate adjunctive measures to prevent suboptimal post-PCI reperfusion.Īll eligible patients who underwent PCI for coronary artery disease with coronary NIRS-IVUS imaging at Korea University Hospital (Seoul, Korea) between April 2016 and June 2020 were prospectively enrolled in this study. High LCBI measured using NIRS-IVUS imaging was an independent predictor of decreased post-PCI TIMI flow. In multivariable analysis, a high LCBI (≥354) was independently associated with slow TIMI flow (OR, 2.59 (95% CI, 1.33–5.04), p = 0.005). ![]() 1.5%, log-rank p = 0.010) in three months of composite events including cardiac death, myocardial infarction, stent thrombosis, and target lesion revascularization. The decreased TIMI flow group showed significantly higher incidence of cardiovascular events (5.6% vs. Decreased TIMI flow (TIMI less than 3) occurred in 90 patients and normal TIMI flow in 546 patients. A high lipid core burden index (LCBI) cut-off point was determined using receiver-operating characteristic analysis. ![]() The primary endpoint was the association between maxLCBI 4 mm and post-interventional TIMI flow. The maximal lipid core burden index over 4-mm segments (maxLCBI 4 mm) per target vessel was calculated. This study evaluated 636 consecutive patients undergoing target-lesion NIRS-IVUS imaging prior to percutaneous coronary intervention (PCI). A combination of near-infrared spectroscopy (NIRS) and intravascular ultrasound (IVUS) could be used to detect lesions at high risk of slow TIMI flow. However, its predictors are not fully known. Decreased thrombolysis in myocardial infarction (TIMI) flow is associated with poor clinical outcomes.
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