Near-infrared spectroscopy predicts events in men and women: Results from the Lipid Rich Plaque study

Frans B. Mensink, Tim J.F. ten Cate, Sander A.J. Damen, Kit Roes, Carlo Di Mario, Varinder Singh, Ziad A. Ali, William Skinner, Andre Artis, Rebecca Torguson, Cheng Zhang, Gheorghe Doros, Hector M. Garcia-Garcia, Gary S. Mintz, Robert Jan van Geuns, Ron Waksman

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Background: The Lipid Rich Plaque (LRP) study demonstrated that near-infrared spectroscopy imaging of non-obstructive lesions identified patients and segments at higher risk for subsequent non-culprit major adverse cardiac events (NC-MACE). Whether this is true for both men and women is not known. In this post hoc analysis of the LRP study, we sought to investigate whether the maximum 4-mm Lipid Core Burden Index (maxLCBI4mm) was of similar predictive value in men and women for NC-MACE. Methods: Patients with an evaluable maxLCBI4mm were stratified on the basis of sex at birth. A Cox proportional-hazards model was used to assess the predictive value of maxLCBI4mm on future NC-MACE at the patient and plaque levels. The primary endpoint was cumulative incidence of NC-MACE at 24 months. Results: Among 1271 patients, 388 (30.5%) were women. Women were older and had a higher cardiovascular risk profile. Cumulative incidence of NC-MACE at 24 months was 10.3% for women and 7.6% for men (log-rank p = 0.11). When comparing maxLCBI4mm > 400 to maxLCBI4mm ≤ 400, the hazard ratio (HR) for future NC-MACE was not significantly different between sexes: 2.10 (95% confidence interval [CI]: 1.28–3.44; p = 0.003) for men and 2.24 (95% CI: 1.18–4.28; p = 0.014) for women (p = 0.87). At the plaque level, the HR comparing maxLCBI4mm > 400 to maxLCBI4mm ≤ 400 was 3.49 (95% CI: 1.60–7.60, p = 0.002) for men and 4.79 (95% CI: 2.02–11.38, p < 0.001) for women, which was not significantly different (p = 0.57). Conclusions: The maxLCBI4mm was of similar predictive value for NC-MACE within 24 months in men and women.

Original languageEnglish
Article number100985
JournalIJC Heart and Vasculature
StatePublished - Apr 2022
Externally publishedYes


  • Intravascular ultrasound
  • Lipid-rich plaque
  • Near-infrared spectroscopy
  • Non-culprit major adverse cardiac events
  • Sex


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