In Vivo Validation of a Catheter-Based Near-Infrared Spectroscopy System for Detection of Lipid Core Coronary Plaques Initial Results of the SPECTACL Study

被引：206

作者：

Waxman, Sergio ^{[1
]}

Dixon, Simon R. ^{[2
]}

L'Allier, Philippe ^{[3
]}

Moses, Jeffrey W. ^{[4
]}

Petersen, John L. ^{[5
]}

Cutlip, Donald ^{[6
]}

Tardif, Jean-Claude ^{[3
]}

Nesto, Richard W. ^{[1
]}

Muller, James E. ^{[7
]}

Hendricks, Michael J. ^{[7
]}

Sum, Stephen T. ^{[7
]}

Gardner, Craig M. ^{[7
]}

Goldstein, James A. ^{[2
]}

Stone, Gregg W. ^{[4
]}

Krucoff, Mitchell W. ^{[5
]}

机构：

[1] Lahey Clin Fdn, Burlington, MA 01805 USA

[2] William Beaumont Hosp, Royal Oak, MI 48072 USA

[3] Montreal Heart Inst, Montreal, PQ H1T 1C8, Canada

[4] Columbia Med Ctr, New York, NY USA

[5] Duke VA Hosp, Durham, NC USA

[6] Beth Israel Deaconess Med Ctr, Boston, MA USA

[7] InfraReDx Inc, Burlington, MA USA

来源：

JACC-CARDIOVASCULAR IMAGING | 2009年 / 2卷 / 07期

关键词：

coronary disease; imaging; spectroscopy; ATHEROSCLEROTIC PLAQUES; VULNERABLE PLAQUES; INTERVENTIONS; CHOLESTEROL; CAP;

D O I：

10.1016/j.jcmg.2009.05.001

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

OBJECTIVES To determine whether catheter-based near-infrared spectroscopy (NIRS) signals obtained with a novel catheter-based system from coronaries of patients are similar to those from autopsy specimens and to assess initial safety of NIRS device. BACKGROUND An intravascular NIRS system for detection of lipid core-containing plaques (LCP) has been validated in human coronary autopsy specimens. The SPECTACL (SPECTroscopic Assessment of Coronary Lipid) trial was a parallel first-in-human multicenter study designed to demonstrate the applicability of the LCP detection algorithm in living patients. METHODS Intracoronary NIRS was performed in patients undergoing percutaneous coronary intervention. Acquired spectra were blindly compared with autopsy NIRS signals with multivariate statistics. To meet the end point of spectral similarity, at least two-thirds of the scans were required to have >80% of spectra similar to the autopsy spectra. RESULTS A total of 106 patients were enrolled; there were no serious adverse events attributed to NIRS. Spectroscopic data could not be obtained in 17 (16%) patients due to technical limitations, leaving 89 patients for analysis. Spectra from 30 patients were unblinded to test the calibration of the LCP detection algorithm. Of the remaining 59 blinded cases, after excluding 11 due to inadequate data, spectral similarity was demonstrated in 40 of 48 spectrally adequate scans (83% success rate, 95% confidence interval: 70% to 93%, median spectral similarity/pullback: 96%, interquartile range 10%). The LCP was detected in 58% of 60 spectrally similar scans from both cohorts. CONCLUSIONS This intravascular NIRS system safely obtained spectral data in patients that were similar to those from autopsy specimens. These results demonstrate the feasibility of invasive detection of coronary LCP with this novel system. (SPECTACL: SPECTroscopic Assessment of Coronary Lipid; NCT00330928) (J Am Coll Cardiol Img 2009; 2: 858-68) (C) 2009 by the American College of Cardiology Foundation

引用

页码：858 / 868

页数：11

共 14 条

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