Читать книгу Interventional Cardiology - Группа авторов - Страница 219

PROSPECT and VIVA were the first prospective studies that used three‐vessel IVUS imaging to examine it is efficacy in detecting nonculprit lesions that are likely to progress and cause cardiovascular ischemi events [5] In PROSPECT [22], a minimum lumen area≤4mm², plaque burden ≥ 70%, and the presence of a TCFA phenotype, derived by virtual histology (VH)‐IVUS, were predictors of subsequent non‐culprit MACE. Lesions with these high risk plaque characteristics were eleven times more likely to cause events within a 3.4‐year follow‐up than simple lesions [hazard ratio (HR): 11.05, P < 0.001]; however, the positive predictive value of these three high‐risk plaque features for subsequent events was low (18.2%). In the light of IVUS limitations in detecting vulnerable plaque [22–25] other imaging modalities including NIR and OCT has the potential value of vulnerable plaque detection (e.g. COMBINE OCT‐FFR; PROSPECT II [26,27] and plaque sealing are promising (PROSPECT II ABSORB; PREVENT Trial NCT02316886 [28].