Definitions and Methodology for the Grayscale and Radiofrequency Intravascular Ultrasound and Coronary Angiographic Analyses

A Maehara, E Cristea, GS Mintz, AJ lansky, O Dressler, S Biro, B Templin, R Virmani, B de Bruyne, PWJC (Patrick) Serruys, GW Stone

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Abstract

OBJECTIVES In a prospective study of the natural history of coronary atherosclerosis using angiography and grayscale and radiofrequency intravascular ultrasound (IVUS)-virtual histology (VH), larger plaque burden, smaller luminal area, and plaque composition thin-cap fibroatheroma emerged as independent predictors of future adverse cardiovascular events. BACKGROUND The methodology for IVUS-VH classification for an in vivo natural history study and the prospective image mapping by angiography and grayscale and IVUS-VH have not been established. METHODS All culprit and nonculprit lesions (defined as >= 30% angiographic visual diameter stenoses) were analyzed. Three epicardial vessels as well as all >= 1.5-mm-diameter side branches were divided into 29 CASS (Coronary Artery Surgery Study) segments. Each CASS segment was then subdivided into 1.5-mm-long subsegments, and dimensions were analyzed. All grayscale and IVUS-VH slices from the proximal 6 to 8 cm of the 3 coronary arteries were analyzed, with lesions defined as having more than 3 RESULTS The 3-year cumulative rate of major adverse cardiovascular events was 20.4%. Events were adjudicated to culprit lesions in 12.9% of patients and to nonculprit lesions in 11.6%. On multivariate analysis, nonculprit lesions associated with recurrent events were characterized by a plaque burden >= 70% (hazard ratio: 5.03; 95% confidence interval: 2.51 to 10.11; p < 0.0001), a minimal luminal area >= 4.0 mm(2) (hazard ratio: 3.21; 95% confidence interval: 1.61 to 6.42; p = 0.001), and IVUS-V CONCLUSIONS Three-vessel multimodality coronary artery imaging was feasible and allowed the identification of lesion-level predictors for future events in this natural history study. (J Am Coll Cardiol Img 2012;5:51-9) (C) 2012 by the American College of Cardiology Foundation
Original languageUndefined/Unknown
Pages (from-to)S1-S9
JournalJACC-cardiovascular imaging
Volume5
Issue number3
DOIs
Publication statusPublished - 2012

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