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Identification of v...
Identification of vulnerable plaques and patients by intracoronary near-infrared spectroscopy and ultrasound (PROSPECT II) : a prospective natural history study
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- Erlinge, David (author)
- Lund University,Lunds universitet,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Molecular Cardiology,Lund University Research Groups,Skåne University Hospital
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- Maehara, Akiko (author)
- Columbia Univ, Irving Med Ctr, NewYork Presbyterian Hosp, New York, NY USA.;Cardiovasc Res Fdn, New York, NY USA.,NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, USA; Cardiovascular Research Foundation, New York, NY, USA
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- Ben-Yehuda, Ori (author)
- Columbia Univ, Irving Med Ctr, NewYork Presbyterian Hosp, New York, NY USA.;Cardiovasc Res Fdn, New York, NY USA.;Univ Calif San Diego, San Diego, CA 92103 USA.,NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, USA; Cardiovascular Research Foundation, New York, NY, USA; University of California San Diego, San Diego, CA, USA
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- Bötker, Hans Erik (author)
- Aarhus Univ Hosp, Aarhus, Denmark.,Aarhus University Hospital, Aarhus, Denmark
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- Maeng, Michael (author)
- Aarhus Univ Hosp, Aarhus, Denmark.,Aarhus University Hospital, Aarhus, Denmark
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- Kjöller-Hansen, Lars (author)
- Univ Hosp, Roskilde, Denmark.,Zealand University Hospital, Roskilde, Denmark
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- Engstrøm, Thomas (author)
- Univ Copenhagen, Copenhagen, Denmark.,University of Copenhagen, Copenhagen, Denmark
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- Matsumura, Mitsuaki (author)
- Cardiovasc Res Fdn, New York, NY USA.,Cardiovascular Research Foundation, New York, NY, USA
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- Crowley, Aaron (author)
- Cardiovasc Res Fdn, New York, NY USA.,Cardiovascular Research Foundation, New York, NY, USA
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- Dressler, Ovidiu (author)
- Cardiovasc Res Fdn, New York, NY USA.,Cardiovascular Research Foundation, New York, NY, USA
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- Mintz, Gary S. (author)
- Cardiovasc Res Fdn, New York, NY USA.,Cardiovascular Research Foundation, New York, NY, USA
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- Fröbert, Ole, 1964- (author)
- Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Örebro Univ, Fac Hlth, Örebro, Sweden.
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- Persson, Jonas (author)
- Karolinska Institutet,Danderyd Hospital
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- Wiseth, Rune (author)
- Trondheim Reg & Univ Hosp, St Olavs Hosp, Trondheim, Norway.,St Olavs Hospital, Trondheim University Hospital, Norway
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- Larsen, Alf Inge (author)
- Stavanger Univ Hosp, Stavanger, Norway.,Stavanger University Hospital, Stavanger, Norway
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- Jensen, Lisette Okkels (author)
- Odense Univ Hosp, Odense, Denmark.,Odense University Hospital, Odense, Denmark
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- Nordrehaug, Jan Erik (author)
- Univ Bergen, Bergen, Norway.,University of Bergen, Bergen, Norway
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- Bleie, Öyvind (author)
- Haukeland Hosp, Bergen, Norway.,Haukeland University Hospital, Bergen, Norway
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- Omerovic, Elmir (author)
- Sahlgrens Univ Hosp, Dept Cardiol, Gothenburg, Sweden.,Department of Cardiology,Sahlgrenska University Hospital, Gothenburg, Sweden
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- Held, Claes, 1956- (author)
- Uppsala University,Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi,Uppsala University and Uppsala Clinical Research Center, Uppsala, Sweden
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- James, Stefan, 1964- (author)
- Uppsala University,Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR),Uppsala University and Uppsala Clinical Research Center, Uppsala, Sweden
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- Ali, Ziad A. (author)
- Columbia Univ, Irving Med Ctr, NewYork Presbyterian Hosp, New York, NY USA.;Cardiovasc Res Fdn, New York, NY USA.,NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, USA; Cardiovascular Research Foundation, New York, NY, USA
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- Muller, James E. (author)
- Brigham & Womens Hosp, 75 Francis St, Boston, MA 02115 USA.,Brigham and Women's Hospital, Boston, MA, USA,Brigham and Women's Hospital / Harvard Medical School
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- Stone, Gregg W. (author)
- Cardiovasc Res Fdn, New York, NY USA.;Icahn Sch Med Mt Sinai, Zena & Michael A Wiener Cardiovasc Inst, New York, NY 10029 USA.,Cardiovascular Research Foundation, New York, NY, USA; The Zena and Michael A Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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- Christersson, Christina (author)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Uppsala kliniska forskningscentrum (UCR)
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- Sarno, Giovanna (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),kardiologi
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(creator_code:org_t)
- Elsevier, 2021
- 2021
- English.
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In: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 397:10278, s. 985-995
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http://dx.doi.org/10...
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https://urn.kb.se/re...
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Abstract
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- Background: Near-infrared spectroscopy (NIRS) and intravascular ultrasound are promising imaging modalities to identify non-obstructive plaques likely to cause coronary-related events. We aimed to assess whether combined NIRS and intravascular ultrasound can identify high-risk plaques and patients that are at risk for future major adverse cardiac events (MACEs).Methods: PROSPECT II is an investigator-sponsored, multicentre, prospective natural history study done at 14 university hospitals and two community hospitals in Denmark, Norway, and Sweden. We recruited patients of any age with recent (within past 4 weeks) myocardial infarction. After treatment of all flow-limiting coronary lesions, three-vessel imaging was done with a combined NIRS and intravascular ultrasound catheter. Untreated lesions (also known as non-culprit lesions) were identified by intravascular ultrasound and their lipid content was assessed by NIRS. The primary outcome was the covariate-adjusted rate of MACEs (the composite of cardiac death, myocardial infarction, unstable angina, or progressive angina) arising from untreated non-culprit lesions during follow-up. The relations between plaques with high lipid content, large plaque burden, and small lumen areas and patient-level and lesion-level events were determined. This trial is registered with ClinicalTrials.gov, NCT02171065.Findings: Between June 10, 2014, and Dec 20, 2017, 3629 non-culprit lesions were characterised in 898 patients (153 [17%] women, 745 [83%] men; median age 63 [IQR 55-70] years). Median follow-up was 3.7 (IQR 3.0-4.4) years. Adverse events within 4 years occurred in 112 (13.2%, 95% CI 11.0-15.6) of 898 patients, with 66 (8.0%, 95% CI 6.2-10.0) arising from 78 untreated non-culprit lesions (mean baseline angiographic diameter stenosis 46.9% [SD 15.9]). Highly lipidic lesions (851 [24%] of 3500 lesions, present in 520 [59%] of 884 patients) were an independent predictor of patient-level non-culprit lesion-related MACEs (adjusted odds ratio 2.27, 95% CI 1.25-4.13) and nonculprit lesion-specific MACEs (7.83, 4.12-14.89). Large plaque burden (787 [22%] of 3629 lesions, present in 530 [59%] of 898 patients) was also an independent predictor of non-culprit lesion-related MACEs. Lesions with both large plaque burden by intravascular ultrasound and large lipid-rich cores by NIRS had a 4-year non-culprit lesion-related MACE rate of 7.0% (95% CI 4.0-10.0). Patients in whom one or more such lesions were identified had a 4-year non-culprit lesion-related MACE rate of 13.2% (95% CI 9.4-17.6).Interpretation: Combined NIRS and intravascular ultrasound detects angiographically non-obstructive lesions with a high lipid content and large plaque burden that are at increased risk for future adverse cardiac outcomes.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Radiologi och bildbehandling (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Radiology, Nuclear Medicine and Medical Imaging (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Publication and Content Type
- ref (subject category)
- art (subject category)
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The Lancet
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- By the author/editor
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Erlinge, David
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Maehara, Akiko
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Ben-Yehuda, Ori
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Bötker, Hans Eri ...
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Maeng, Michael
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Kjöller-Hansen, ...
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show more...
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Engstrøm, Thomas
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Matsumura, Mitsu ...
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Crowley, Aaron
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Dressler, Ovidiu
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Mintz, Gary S.
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Fröbert, Ole, 19 ...
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Persson, Jonas
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Wiseth, Rune
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Larsen, Alf Inge
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Jensen, Lisette ...
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Nordrehaug, Jan ...
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Bleie, Öyvind
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Omerovic, Elmir
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Held, Claes, 195 ...
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James, Stefan, 1 ...
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Ali, Ziad A.
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Muller, James E.
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Stone, Gregg W.
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Christersson, Ch ...
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Sarno, Giovanna
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Radiology Nuclea ...
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MEDICAL AND HEAL ...
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The Lancet
- By the university
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Uppsala University
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Örebro University
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Karolinska Institutet
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Lund University