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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

View larger version (11K): [in a new window]   Figure 1 Difference in atherosclerotic plaque temperature from background temperature (T) in the three subgroups. Temperature differences increase progressively from effort angina (EA) to acute myocardial infarction (AMI). The bottom of the box represents the first quartile; the top of the box represents the third quartile; and the line in the box represents the median value of T. UA = unstable angina.

View larger version (10K): [in a new window]   Figure 2 Difference in atherosclerotic plaque temperature from background temperature (T) between patients with an adverse cardiac event during the follow-up period and those without an adverse outcome. The bottom of the box represents the first quartile; the top of the box represents the third quartile; and the line in the box represents the median value of T.

View larger version (12K): [in a new window]   Figure 3 The difference in atheromatous plaque temperature from background temperature (T) was greater in patients with effort angina (EA) and unstable angina (UA) with adverse cardiac events than in patients without events. In patients with acute myocardial infarction (AMI), T was greater in patients with an adverse outcome, although T did not reach statistical significance. The bottom of the box represents the first quartile; the top of the box represents the third quartile; and the line in the box represents the median value of T.

View larger version (12K): [in a new window]   Figure 4 Receiver-operating characteristics (ROC) graph showing the percentage of correct prediction of events (sensitivity) and the percentage of correct prediction of no events (specificity) during the follow-up period, as function of the difference in atherosclerotic plaque temperature from background temperature. According to this curve, we can detect a point on it by the increase in sensitivity, with satisfactory specificity, and then estimate the threshold value. The closer the ROC curve is to the upper left-hand corner of the graph, the more accurate it is, because the true positive rate is 1 and the false-positive rate is 0. The area under the ROC curve was 77%.

View larger version (12K): [in a new window]   Figure 5 Estimated survival among the study group according to temperature difference (T). The risk of an adverse cardiac event in patients with T >0.5°C is significantly increased, as compared with that in patients with T <0.5°C.