Association between High Lipid Burden of Target Lesion and Slow TIMI Flow in Coronary Interventions

Subin Lim, Jung Joon Cha, Soon Jun Hong, Ju Hyeon Kim, Hyung Joon Joo, Jae Hyoung Park, Cheol Woong Yu, Tae Hoon Ahn, Do Sun Lim

Research output: Contribution to journalArticlepeer-review

Abstract

Decreased thrombolysis in myocardial infarction (TIMI) flow is associated with poor clinical outcomes. However, its predictors are not fully known. A combination of near-infrared spectroscopy (NIRS) and intravascular ultrasound (IVUS) could be used to detect lesions at high risk of slow TIMI flow. This study evaluated 636 consecutive patients undergoing target-lesion NIRS-IVUS imaging prior to percutaneous coronary intervention (PCI). The maximal lipid core burden index over 4-mm segments (maxLCBI4mm) per target vessel was calculated. The primary endpoint was the association between maxLCBI4mm and post-interventional TIMI flow. A high lipid core burden index (LCBI) cut-off point was determined using receiver-operating characteristic analysis. Decreased TIMI flow (TIMI less than 3) occurred in 90 patients and normal TIMI flow in 546 patients. The decreased TIMI flow group showed significantly higher incidence of cardiovascular events (5.6% vs. 1.5%, log-rank p = 0.010) in three months of composite events including cardiac death, myocardial infarction, stent thrombosis, and target lesion revascularization. In multivariable analysis, a high LCBI (≥354) was independently associated with slow TIMI flow (OR, 2.59 (95% CI, 1.33–5.04), p = 0.005). High LCBI measured using NIRS-IVUS imaging was an independent predictor of decreased post-PCI TIMI flow. Performing PCI for high-LCBI lesions may necessitate adjunctive measures to prevent suboptimal post-PCI reperfusion.

Original languageEnglish
Article number5401
JournalJournal of Clinical Medicine
Volume11
Issue number18
DOIs
Publication statusPublished - 2022 Sep
Externally publishedYes

Keywords

  • intravascular ultrasound
  • lipid core burden index
  • near-infrared spectroscopy
  • percutaneous coronary intervention
  • thrombolysis in myocardial infarction

ASJC Scopus subject areas

  • Medicine(all)

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