Document Detail

In vivo validation of a catheter-based near-infrared spectroscopy system for detection of lipid core coronary plaques: initial results of the SPECTACL study.
MedLine Citation:
PMID:  19608137     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To determine whether catheter-based near-infrared spectroscopy (NIRS) signals obtained with a novel catheter-based system from coronaries of patients are similar to those from autopsy specimens and to assess initial safety of NIRS device. BACKGROUND: An intravascular NIRS system for detection of lipid core-containing plaques (LCP) has been validated in human coronary autopsy specimens. The SPECTACL (SPECTroscopic Assessment of Coronary Lipid) trial was a parallel first-in-human multicenter study designed to demonstrate the applicability of the LCP detection algorithm in living patients. METHODS: Intracoronary NIRS was performed in patients undergoing percutaneous coronary intervention. Acquired spectra were blindly compared with autopsy NIRS signals with multivariate statistics. To meet the end point of spectral similarity, at least two-thirds of the scans were required to have >80% of spectra similar to the autopsy spectra. RESULTS: A total of 106 patients were enrolled; there were no serious adverse events attributed to NIRS. Spectroscopic data could not be obtained in 17 (16%) patients due to technical limitations, leaving 89 patients for analysis. Spectra from 30 patients were unblinded to test the calibration of the LCP detection algorithm. Of the remaining 59 blinded cases, after excluding 11 due to inadequate data, spectral similarity was demonstrated in 40 of 48 spectrally adequate scans (83% success rate, 95% confidence interval: 70% to 93%, median spectral similarity/pullback: 96%, interquartile range 10%). The LCP was detected in 58% of 60 spectrally similar scans from both cohorts. CONCLUSIONS: This intravascular NIRS system safely obtained spectral data in patients that were similar to those from autopsy specimens. These results demonstrate the feasibility of invasive detection of coronary LCP with this novel system. (SPECTACL: SPECTroscopic Assessment of Coronary Lipid; NCT00330928).
Sergio Waxman; Simon R Dixon; Philippe L'Allier; Jeffrey W Moses; John L Petersen; Donald Cutlip; Jean-Claude Tardif; Richard W Nesto; James E Muller; Michael J Hendricks; Stephen T Sum; Craig M Gardner; James A Goldstein; Gregg W Stone; Mitchell W Krucoff
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; Validation Studies    
Journal Detail:
Title:  JACC. Cardiovascular imaging     Volume:  2     ISSN:  1876-7591     ISO Abbreviation:  JACC Cardiovasc Imaging     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-17     Completed Date:  2009-09-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101467978     Medline TA:  JACC Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  858-68     Citation Subset:  IM    
Lahey Clinic, Burlington, Massachusetts 01805, USA.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary
Coronary Angiography
Coronary Artery Disease / diagnosis*,  metabolism,  therapy
Coronary Vessels / chemistry*,  pathology
Equipment Design
Feasibility Studies
Heart Catheterization* / instrumentation
Lipids / analysis*
Middle Aged
Predictive Value of Tests
Reproducibility of Results
Spectroscopy, Near-Infrared* / instrumentation
United States
Reg. No./Substance:

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