Near-infrared spectroscopy predicts cardiovascular outcome in patients with coronary artery disease

J Am Coll Cardiol. 2014 Dec 16;64(23):2510-8. doi: 10.1016/j.jacc.2014.07.998.


Background: Near-infrared spectroscopy (NIRS) is capable of identifying lipid core-containing plaques, which can subsequently be quantified as a lipid core burden index (LCBI). Currently, no data are available on the long-term prognostic value of NIRS in patients with coronary artery disease (CAD).

Objectives: This study sought to determine the long-term prognostic value of intracoronary NIRS as assessed in a nonculprit vessel in patients with CAD.

Methods: In this prospective, observational study, NIRS imaging was performed in a nonculprit coronary artery in 203 patients referred for angiography due to stable angina pectoris (SAP) or acute coronary syndrome (ACS). The primary endpoint was the composite of all-cause mortality, nonfatal ACS, stroke, and unplanned coronary revascularization.

Results: The 1-year cumulative incidence of the primary endpoint was 10.4%. Cumulative 1-year rates in patients with an LCBI equal to and above the median (43.0) versus those with LCBI values below the median were 16.7% versus 4.0% (adjusted hazard ratio: 4.04; 95% confidence interval: 1.33 to 12.29; p = 0.01). The relation between LCBI and the primary endpoint was similar in SAP and ACS patients (p value for heterogeneity = 0.14). Similar differences between high and low LCBI were observed in pre-specified secondary endpoints.

Conclusion: CAD patients with an LCBI equal to or above the median of 43.0, as assessed by NIRS in a nonculprit coronary artery, had a 4-fold risk of adverse cardiovascular events during 1-year follow-up. This observation warrants confirmation by larger studies with extended follow-up. (The European Collaborative Project on Inflammation and Vascular Wall Remodeling in Atherosclerosis - Intravascular Ultrasound Study [AtheroRemoIVUS]; NCT01789411).

Keywords: atherosclerosis; intracoronary imaging; risk stratification.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Coronary Syndrome / epidemiology
  • Coronary Artery Disease / epidemiology
  • Coronary Artery Disease / pathology*
  • Female
  • Follow-Up Studies
  • Humans
  • Lipids
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Revascularization / statistics & numerical data
  • Netherlands / epidemiology
  • Plaque, Atherosclerotic / pathology
  • Prognosis
  • Prospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Spectroscopy, Near-Infrared*
  • Stroke / epidemiology


  • Lipids

Associated data