Optical coherence tomography-derived lipid core burden index and clinical outcomes: results from the CLIMA registry

Flavio Giuseppe Biccirè, Simone Budassi, Yukio Ozaki, Alberto Boi, Enrico Romagnoli, Riccardo Di Pietro, Christos V. Bourantas, Valeria Marco, Giulia Paoletti, Caterina Debelak, Emanuele Sammartini, Francesco Versaci, Franco Fabbiocchi, Francesco Burzotta, Daniele Pastori, Filippo Crea, Eloisa Arbustini, Fernando Alfonso, Francesco Prati

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


Aims The aim of this study was to assess the morphological characteristics and prognostic implications of the optical coherence tomography (OCT)-derived lipid core burden index (LCBI). Methods OCT-LCBI was assessed in 1003 patients with 1-year follow-up from the CLIMA multicentre registry using a validated and results software able to automatically obtain a maximum OCT-LCBI in 4 mm (maxOCT-LCBI4mm). Primary composite clinical endpoint included cardiac death, myocardial infarction, and target-vessel revascularization. A secondary analysis using clinical outcomes of CLIMA study was performed. Patients with a maxOCT-LCBI4mm ≥ 400 showed higher prevalence of fibrous cap thickness (FCT),75 μm [odds ratio (OR) 1.43, 95% confidence interval (CI) 1.03–1.99; P= 0.034], lipid pool arc .180° (OR 3.93, 95%CI 2.97–5.21; P, 0.001), minimum lumen area,3.5 mm2 (OR 1.5, 95%CI 1.16–1.94; P= 0.002), macrophage infiltration (OR 2.38, 95%CI 1.81–3.13; P, 0.001), and intra-plaque intimal vasculature (OR 1.34, 95%CI 1.05–1.72; P= 0.021). A maxOCT-LCBI4mm ≥400 predicted the primary endpoint [adjusted hazard ratio (HR) 1.86, 95%CI 1.1–3.2; P= 0.019] as well as the CLIMA endpoint (HR 2.56, 95%CI 1.24–5.29; P= 0.011). Patients with high lipid content and thin FCT, 75 µm were at higher risk for adverse events (HR 4.88, 95%CI 2.44–9.72; P, 0.001). Conclusions A high maxOCT-LCBI4mm was related to poor outcome and vulnerable plaque features. This study represents a step further in the automated assessment of the coronary plaque risk profile.

Original languageEnglish
Pages (from-to)437-445
Number of pages9
JournalEuropean Heart Journal Cardiovascular Imaging
Issue number4
Publication statusPublished - 01-04-2023
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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