Optical coherence tomography-derived lipid core burden index and clinical outcomes: results from the CLIMA registry

doi:10.1093/ehjci/jeac110

Prevention & lipids

Optical coherence tomography-derived lipid core burden index and clinical outcomes: results from the CLIMA registry

Eur Heart J Cardiovasc ImagingPublished 20 Jun 2022Prospective registry study

Main finding · Primary composite endpointResultAdjusted hazard ratio 1.86 95% CI 1.1–3.2

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Authors' conclusion

A high maxOCT-LCBI4mm was related to poor outcome and vulnerable plaque features.

Study context

Population: Patients undergoing optical coherence tomography (OCT) in the CLIMA multicentre registry with 1-year follow-up
Participants: 1,003 patients

Exposure: maxOCT-LCBI4mm ≥400 vs <400
Outcome: Composite of:
Cardiac death
MI
Target-vessel revascularization
Follow-up: 1 year

Methodological detailsmulticentre

Multicentre

Main finding

Primary composite endpoint

Adjusted hazard ratio

1.86

95% CI 1.1–3.2

P = 0.019

maxOCT-LCBI4mm ≥400vs maxOCT-LCBI4mm <400

adjusted HR 1.86 (95% CI 1.1–3.2); P = 0.019

As reported in the abstract

Observational data: associations, not effects.

Further findings

Outcome	← Lower with maxOCT-LCBI4mm ≥400 ←→ Higher with maxOCT-LCBI4mm ≥400 →	Estimate	P value
CLIMA endpoint	0.20.5125	HR 2.56 (95% CI 1.24–5.29)	P = 0.011
Vulnerable plaque features with maxOCT-LCBI4mm ≥400maxOCT-LCBI4mm ≥400vs maxOCT-LCBI4mm <400FCT <75 μm	0.20.5125	OR 1.43 (95% CI 1.03–1.99)	P = 0.034
Vulnerable plaque features with maxOCT-LCBI4mm ≥400maxOCT-LCBI4mm ≥400vs maxOCT-LCBI4mm <400Lipid pool arc >180°	0.20.5125	OR 3.93 (95% CI 2.97–5.21)	P < 0.001
Vulnerable plaque features with maxOCT-LCBI4mm ≥400maxOCT-LCBI4mm ≥400vs maxOCT-LCBI4mm <400Minimum lumen area <3.5 mm²	0.20.5125	OR 1.5 (95% CI 1.16–1.94)	P = 0.002
Vulnerable plaque features with maxOCT-LCBI4mm ≥400maxOCT-LCBI4mm ≥400vs maxOCT-LCBI4mm <400Macrophage infiltration	0.20.5125	OR 2.38 (95% CI 1.81–3.13)	P < 0.001
Vulnerable plaque features with maxOCT-LCBI4mm ≥400maxOCT-LCBI4mm ≥400vs maxOCT-LCBI4mm <400Intra-plaque intimal vasculature	0.20.5125	OR 1.34 (95% CI 1.05–1.72)	P = 0.021
	0.20.5125Ratio (log scale)

Adverse events with high lipid content and thin fibrous cap thickness (FCT) <75 µm

	← Lower risk ←→ Higher risk →	HR (95% CI)	P value
High lipid content + FCT <75 µm	0.10.31310	4.88 (2.44–9.72)	P < 0.001
	0.10.31310Hazard ratio (log scale)

Original publication

Optical coherence tomography-derived lipid core burden index and clinical outcomes: results from the CLIMA registry. Eur Heart J Cardiovasc Imaging. Published 20 June 2022. doi:10.1093/ehjci/jeac110

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