Near-infrared spectroscopy predicts events in men and women: Results from the Lipid Rich Plaque study
Frans B Mensink1, Tim J F Ten Cate1, Sander A J Damen1
1Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands.
Insights
The maximum 4-mm Lipid Core Burden Index (maxLCBI4mm) effectively predicts major adverse cardiac events in both men and women. This imaging technique offers similar risk assessment value across sexes for non-obstructive coronary lesions.
Area of Science:
- Cardiology
- Medical Imaging
- Vascular Biology
Background:
- The Lipid Rich Plaque (LRP) study previously identified near-infrared spectroscopy imaging of non-obstructive lesions as a risk predictor for major adverse cardiac events (MACE).
- The predictive value of the maximum 4-mm Lipid Core Burden Index (maxLCBI4mm) derived from this imaging technique has not been previously evaluated separately for men and women.
- Understanding sex-based differences in risk prediction is crucial for personalized cardiovascular disease management.
Purpose of the Study:
- To investigate whether the maxLCBI4mm has similar predictive value for non-culprit major adverse cardiac events (NC-MACE) in men and women.
- To assess the performance of maxLCBI4mm in identifying patients and plaque segments at higher risk for future cardiac events, stratified by sex.
Main Methods:
- A post hoc analysis of the LRP study was conducted, including 1271 patients stratified by sex at birth.
- Cox proportional-hazards models were used to evaluate the predictive value of maxLCBI4mm for NC-MACE at both patient and plaque levels over 24 months.
- The primary endpoint was the cumulative incidence of NC-MACE at 24 months.
Main Results:
- Women (30.5%) were older and had a higher cardiovascular risk profile than men.
- The cumulative incidence of NC-MACE at 24 months was 10.3% for women and 7.6% for men (p=0.11).
- The hazard ratio for NC-MACE associated with maxLCBI4mm > 400 versus ≤ 400 was not significantly different between sexes at the patient level (p=0.87) or plaque level (p=0.57).
Conclusions:
- The maxLCBI4mm demonstrates similar predictive value for NC-MACE within 24 months in both men and women.
- Near-infrared spectroscopy imaging and the maxLCBI4mm are valuable tools for risk stratification in diverse patient populations.
- These findings support the use of maxLCBI4mm for assessing cardiovascular risk in non-obstructive coronary lesions, irrespective of sex.
Background:
The Lipid Rich Plaque (LRP) study demonstrated that near-infrared spectroscopy imaging of non-obstructive lesions identified patients and segments at higher risk for subsequent non-culprit major adverse cardiac events (NC-MACE). Whether this is true for both men and women is not known. In this post hoc analysis of the LRP study, we sought to investigate whether the maximum 4-mm Lipid Core Burden Index (maxLCBI4mm) was of similar predictive value in men and women for NC-MACE.
Methods:
Patients with an evaluable maxLCBI4mm were stratified on the basis of sex at birth. A Cox proportional-hazards model was used to assess the predictive value of maxLCBI4mm on future NC-MACE at the patient and plaque levels. The primary endpoint was cumulative incidence of NC-MACE at 24 months.
Results:
Among 1271 patients, 388 (30.5%) were women. Women were older and had a higher cardiovascular risk profile. Cumulative incidence of NC-MACE at 24 months was 10.3% for women and 7.6% for men (log-rank p = 0.11). When comparing maxLCBI4mm > 400 to maxLCBI4mm ≤ 400, the hazard ratio (HR) for future NC-MACE was not significantly different between sexes: 2.10 (95% confidence interval [CI]: 1.28-3.44; p = 0.003) for men and 2.24 (95% CI: 1.18-4.28; p = 0.014) for women (p = 0.87). At the plaque level, the HR comparing maxLCBI4mm > 400 to maxLCBI4mm ≤ 400 was 3.49 (95% CI: 1.60-7.60, p = 0.002) for men and 4.79 (95% CI: 2.02-11.38, p < 0.001) for women, which was not significantly different (p = 0.57).
Conclusions:
The maxLCBI4mm was of similar predictive value for NC-MACE within 24 months in men and women.
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