Characterization of plaque phenotypes exhibiting an elevated pericoronary adipose tissue attenuation: insights from the REASSURE-NIRS registry

Figures

• 

  Fig. 1. The correlation between NIRS/IVUS-derived plaque features and PCATRCA attenuation. A MaxLCBI4mm, B Plaque burden, C Remodeling index. IVUS= ntravascular ultrasound, NIRS= near infrared spectroscopy, PCAT= pericoronary adipose tissue, maxLCBI4mm = maximum-4 mm lipid core burden index, RCA= right coronary artery

• 

  Fig. 2. The median PCATRCA attenuation and the number of NIRS/IVUS-derived plaque features. IVUS= intravascular ultrasound, NIRS= near infrared spectroscopy, PCAT= pericoronary adipose tissue, RCA= right coronary artery

• 

  Fig. 3. Receiver operating characteristics curve analysis to predict vulnerable plaques. Three models were used to evaluate the predictive ability of NIRS/IVUS-derived vulnerable plaque (= maxLCBI4mm > 400 + plaque burden > 70% + spotty calcification). Model 1: age, sex, and dyslipidemia (light blue). Model 2: model 1+LDL-C ≥ 1.8 mmol/L) (green). Model 3: model 2+PCATRCA attenuation ≥ -78.3 HU (red)

• 

  Fig. 4. Representative cases with or without high vascular inflammation. A 77 years old male with stable coronary artery disease. Coronary angiography demonstrated that moderate stenosis in his middle left descending artery (LAD). B Grey-scale intravascular ultrasound (IVUS) showed calcified plaque with no attenuation in the culprit lesion. C Near-infrared spectroscopy chemogram revealed that there was less lipid accumulation in the culprit lesion (maxLCBI4mm = 292). D In coronary computed tomography angiography (CCTA) analysis, his pericoronary adipose tissue attenuation at proximal RCA was low (PCATRCA attenuation = − 98.1 HU). E 85 years old male with stable coronary artery disease. Coronary angiography demonstrated that severe stenosis in his middle LAD. F Grey-scale IVUS showed low echoic plaque with attenuation in the culprit lesion. G NIRS chemogram revealed that there was large lipid burden in the culprit lesion (maxLCBI4mm = 465). H In CCTA analysis, he had high coronary artery inflammation (PCATRCA attenuation = − 72.7 HU)