Increased local temperature in human coronary atherosclerotic plaques: An independent predictor of clinical outcome in patients undergoing a percutaneous coronary intervention

OBJECTIVES We investigated the midterm clinical significance of human coronary atherosclerotic plaques temperature after a successful percutaneous coronary intervention. BACKGROUND Previous studies have shown an increased temperature in human atherosclerotic plaques. However, the prognostic significance of atherosclerotic plaque temperature in patients undergoing a successful percutaneous intervention is unknown. METHODS We prospectively investigated the relation between the temperature difference (DeltaT) between the atherosclerotic plaque and the healthy vessel wall and event-free survival among 86 patients undergoing a successful percutaneous intervention. Temperature was measured by a thermography catheter, as previously validated. The study group consisted of patients with effort angina (EA) (34.5%), unstable angina (UA) (34.5%) and acute myocardial infarction (AMI) (30%). RESULTS The DeltaT increased progressively from EA to AMI (0.132 +/- 0.18 degreesC in EA, 0.637 +/- 0.26 degreesC in UA and 0.942 +/- 0.58 degreesC in AMI). The median clinical follow-up period was 17.88 +/- 7.16 months. The DeltaT was greater in patients with adverse cardiac events than in patients without events (DeltaT: 0.939 +/- 0.49 degreesC vs. 0.428 +/- 0.42 degreesC; p < 0.0001). The <Delta>T was a strong predictor of adverse cardiac events during the follow-up period (odds ratio 2.14, p = 0.043). The threshold of the DeltaT value, above which the risk fbr an adverse cardiac event was significantly increased, was 0.5 degreesC. The incidence of adverse cardiac events in patients with DeltaT greater than or equal to0.5 degreesC was 41%, as compared with 7% in patients with DeltaT <0.5<degrees>C (p < 0.001). CONCLUSIONS Increased local temperature in atherosclerotic plaques is a strong predictor of an unfavorable clinical outcome in patients with coronary artery disease undergoing percutaneous interventions. a Am Cell Cardiol 2001;37:1277- 83) (C) 2001 by the American College of Cardiology.