Discordance in the diagnostic assessment of vulnerable plaques between radiofrequency intravascular ultrasound versus optical coherence tomography among patients with acute myocardial infarction: insights from the IBIS-4 study.

Ueki, Yasushi; Yamaji, Kyohei; Losdat, Sylvain; Karagiannis, Alexios; Taniwaki, Masanori; Roffi, Marco; Otsuka, Tatsuhiko; Koskinas, Konstantinos C.; Holmvang, Lene; Maldonado, Rafaela; Pedrazzini, Giovanni; Radu, Maria D; Dijkstra, Jouke; Windecker, Stephan; Garcia-Garcia, Hector M; Räber, Lorenz (2021). Discordance in the diagnostic assessment of vulnerable plaques between radiofrequency intravascular ultrasound versus optical coherence tomography among patients with acute myocardial infarction: insights from the IBIS-4 study. International journal of cardiovascular imaging, 37(10), pp. 2839-2847. Springer 10.1007/s10554-021-02272-6

[img]
Preview
Text
Ueki_IntJCardiovascImaging_2021.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (1MB) | Preview

We aimed to evaluate the diagnostic agreement between radiofrequency (RF) intravascular ultrasound (IVUS) and optical coherence tomography (OCT) for thin-cap fibroatheroma (TCFA) in non-infarct-related coronary arteries (non-IRA) in patients with ST-segment elevation myocardial infarction (STEMI). In the Integrated Biomarker Imaging Study (IBIS-4), 103 STEMI patients underwent OCT and RF-IVUS imaging of non-IRA after successful primary percutaneous coronary intervention and at 13-month follow-up. A coronary lesion was defined as a segment with ≥ 3 consecutive frames (≈1.2 mm) with plaque burden ≥ 40% as assessed by grayscale IVUS. RF-IVUS-derived TCFA was defined as a lesion with > 10% confluent necrotic core abutting to the lumen in > 10% of the circumference. OCT-TCFA was defined by a minimum cap thickness < 65 μm. The two modalities were matched based on anatomical landmarks using a dedicated matching software. Using grayscale IVUS, we identified 276 lesions at baseline (N = 146) and follow-up (N = 130). Using RF-IVUS, 208 lesions (75.4%) were classified as TCFA. Among them, OCT identified 14 (6.7%) TCFA, 60 (28.8%) thick-cap fibroatheroma (ThCFA), and 134 (64.4%) non-fibroatheroma. All OCT-TCFA (n = 14) were confirmed as RF-TCFA. The concordance rate between RF-IVUS and OCT for TCFA diagnosis was 29.7%. The reasons for discordance were: OCT-ThCFA (25.8%); OCT-fibrous plaque (34.0%); attenuation due to calcium (23.2%); attenuation due to macrophage (10.3%); no significant attenuation (6.7%). There was a notable discordance in the diagnostic assessment of TCFA between RF-IVUS and OCT. The majority of RF-derived TCFA were not categorized as fibroatheroma using OCT, while all OCT-TCFA were classified as TCFA by RF-IVUS.ClinicalTrials.gov Identifier NCT00962416.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Pre-clinic Human Medicine > Department of Clinical Research (DCR)

UniBE Contributor:

Ueki, Yasushi, Losdat, Sylvain Pierre, Karagiannis Voules, Alexios, Otsuka, Tatsuhiko, Koskinas, Konstantinos, Windecker, Stephan, Räber, Lorenz

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1569-5794

Publisher:

Springer

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

27 Jul 2021 12:25

Last Modified:

20 Feb 2024 14:16

Publisher DOI:

10.1007/s10554-021-02272-6

PubMed ID:

34236570

Additional Information:

Open Access funding provided by Universität Bern.

Uncontrolled Keywords:

Fibroatheroma Intravascular ultrasound Optical coherence tomography Radiofrequency

BORIS DOI:

10.48350/157526

URI:

https://boris.unibe.ch/id/eprint/157526

Actions (login required)

Edit item Edit item
Provide Feedback