Intracoronary imaging of all three coronary arteries with a combination NIRS-IVUS catheter was safe in patients with acute myocardial infarction, based on findings from the PROSPECT II study presented Oct. 14 during TCT 2020.

David Erlinge, MD, PhD, FACC, et al., assessed data from 902 patients with recent STEMI (22.2%) and NSTEMI (77.8%) across centers in Denmark, Sweden and Norway. The median age was 63 and 17% were female. After successful treatment of all flow-limiting lesions with contemporary drug-eluting stents (DES), intravascular imaging was performed in the proximal 6-10 cm of all three coronary arteries, according to Erlinge. Untreated non-culprit lesions were prospectively identified by IVUS and their lipid content was assessed by blinded NIRS.

Results showed the primary outcome – major adverse cardiovascular events during median follow-up of 3.7 years – occurred in 14.4% of patients, of which 8% was caused by unanticipated events arising from untreated non-flow-limiting plagues and 4.6% caused by recurrent events at treated culprit lesions. The primary safety outcome – intravascular imaging-related major complications requiring treatment – occurred in two patients (0.2%).

Erlinge, et al., note that NIRS identified “lipid-rich angiographically mild non-flow-limiting plaques that were responsible for future coronary events.”

Clinical Topics: Invasive Cardiovascular Angiography and Intervention, Atherosclerotic Disease (CAD/PAD), Interventions and Coronary Artery Disease, Interventions and Imaging, Angiography, Nuclear Imaging

Keywords: TCT20, Transcatheter Cardiovascular Therapeutics, Myocardial Infarction, Coronary Artery Disease, Angiography, Percutaneous Coronary Intervention

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