Coronary artery disease is caused by the narrowing or blockage of arteries that supply the heart with blood. Despite recent advances in the treatment and care of patients with coronary artery disease, it remains the leading cause of morbidity and mortality in the developed world. The condition is often associated with adverse health events including heart attacks and sudden death. These adverse events can occur following the rupture and release of lipid-rich plaques (LRP). Researchers believe that technologies that can identify vulnerable plaques and segments of the blood vessels that may experience rupture may allow us to prioritize individuals that may be at a higher risk of secondary adverse cardiac events. One such technology that has recently been shown to have potential in predicting future adverse events is near-infrared spectroscopy (NIRS) intravascular ultrasound imaging.
A recent prospective study, published in The Lancet, investigated the potential of using (NIRS) intravascular ultrasound imaging in detecting LRPs, and whether this information can be used to identify at-risk individuals. Specifically, a total of 1563 patients were enrolled from 44 medical centres located in Italy, Latvia, Netherlands, Slovakia, United Kingdom, and the United States. Of these, only 1271 patients, followed for approximately 24-months, had analyzable data.
In brief, 9% of all patients experienced a major adverse cardiac event. Patients with a higher burden of LRPs were associated with an elevated risk of major adverse cardiac events before and after adjusting for potential confounding factors. The findings in this study demonstrate that NIRS intravascular ultrasound imaging is a safe and effective strategy for predicting future adverse events in at-risk populations. The addition of this technology as a diagnostic tool will allow healthcare professionals to detect vulnerable plaques and patients.
Written by Haisam Shah, B.Sc
Reference: Waksman, R., Di Mario, C., Torguson, R., Ali, Z. A., Singh, V., Skinner, W. H., … & Regar, E. (2019). Identification of patients and plaques vulnerable to future coronary events with near-infrared spectroscopy intravascular ultrasound imaging: a prospective, cohort study. The Lancet.
Image by Gerd Altmann from Pixabay