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CLINICAL STUDY

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

^a Department of Cardiology, Athens Medical School, Athens, Greece

Manuscript received August 8, 2000; revised manuscript received November 14, 2000, accepted December 20, 2000.

Reprint requests and correspondence: Dr. Christodoulos Stefanadis, 9 Tepeleniou Street, 15452 Paleo Psychico, Athens, Greece
cstefan{at}cc.uoa.gr

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 (T) 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 T increased progressively from EA to AMI (0.132 ± 0.18°C in EA, 0.637 ± 0.26°C in UA and 0.942 ± 0.58°C in AMI). The median clinical follow-up period was 17.88 ± 7.16 months. The T was greater in patients with adverse cardiac events than in patients without events (T: 0.939 ± 0.49°C vs. 0.428 ± 0.42°C; p < 0.0001). The 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 T value, above which the risk for an adverse cardiac event was significantly increased, was 0.5°C. The incidence of adverse cardiac events in patients with T 0.5°C was 41%, as compared with 7% in patients with T <0.5°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.

Abbreviations and Acronyms   AMI = acute myocardial infarction   T = temperature difference   AUC = area under the curve   EA = effort angina   IVUS = intravascular ultrasound   OR = odds ratio   ROC = receiver-operating characteristics   ROI = region of interest   SA = stable angina   UA = unstable angina

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