Prediction of Slow-Flow Phenomenon After Stent Implantation Using Near-Infrared Spectroscopy in Patients With Acute and Chronic Coronary Syndrome.

Abstract

BACKGROUND:

The slow-flow phenomenon is associated with worse clinical outcomes after percutaneous coronary intervention (PCI), so our goal for this study was to see how predictive how near-infrared spectroscopy (NIRS) could be.Methods and Results: We enrolled 179 lesions from 152 patients who had de novo coronary stent implantation guided by NIRS-intravascular ultrasound (IVUS) (male: 69.1%, mean age: 74.3±11.5 years, acute coronary syndrome: 65.1%, diabetes: 42.1%). NIRS automatically determined the maximum 4-mm lipid core burden index (maxLCBI4 mm) value at pre- and post-PCI procedures. The slow-flow phenomenon was defined as the deterioration of TIMI (Thrombolysis in Myocardial Infarction) flows on angiography during the PCI procedure in the absence of mechanical obstruction. The slow-flow phenomenon occurred in 13 (7.3%) lesions, and the slow-flow phenomenon group had a significantly higher maxLCBI4 mm(740±147 vs. 471±223, P<0.001). The best maxLCBI4 mmcutoff point in both acute and chronic coronary syndrome was 578 and 480, with sensitivity of 100%, for predicting the slow-flow phenomenon. In the receiver-operating characteristics analysis, the area under the curve for acute and chronic coronary syndrome was 0.849 and 0.851, respectively.

CONCLUSIONS:

The results of this study support the utility of NIRS-IVUS-guided PCI for the prediction of the slow-flow phenomenon.

• Authors: Nobuaki Suzuki, Tatsuru Yokoi, Takahiro Kimura, Yoshiyuki Ikeda, Shinji Takahashi, Takashi Aoyagi, Yoshitaka Shiratori, Noriyuki Hayami, Ken Kozuma
• Journal: Circulation journal : official journal of the Japanese Circulation Society (Circ J) (Oct 12 2023) ISSN: 1347-4820 [Electronic] Japan
• PMID: 37821388 (Publication Type: Journal Article)