From the Research
The PROSPECT II trial found that combined near-infrared spectroscopy and intravascular ultrasound imaging can identify high-risk plaques and patients at risk for future major adverse cardiac events (MACEs) with a 4-year non-culprit lesion-related MACE rate of 7.0% for lesions with large plaque burden and large lipid-rich cores. The trial, which included 898 patients with recent myocardial infarction, used a combined NIRS and IVUS catheter to assess untreated non-culprit lesions and found that highly lipidic lesions and large plaque burden were independent predictors of patient-level non-culprit lesion-related MACEs 1. The study highlights the potential value of comprehensive 3-vessel imaging assessment to evaluate plaque phenotype for more accurate risk stratification of patients admitted with acute coronary syndrome.
- Key findings of the PROSPECT II trial include:
- Highly lipidic lesions were an independent predictor of patient-level non-culprit lesion-related MACEs with an adjusted odds ratio of 2.27 (95% CI 1.25-4.13) 1
- Large plaque burden was also an independent predictor of non-culprit lesion-related MACEs 1
- Lesions with both large plaque burden and large lipid-rich cores had a 4-year non-culprit lesion-related MACE rate of 7.0% (95% CI 4.0-10.0) 1
- Patients with one or more such lesions had a 4-year non-culprit lesion-related MACE rate of 13.2% (95% CI 9.4-17.6) 1 The PROSPECT II trial provides evidence that combined NIRS and IVUS imaging can identify patients and plaques at high risk for future coronary events, which can inform treatment decisions and improve patient outcomes 1.