BACKGROUND: Whereas acute coronary syndromes (ACS) typically develop from the rupture of lipid core plaque (LCP), lesions causing stable angina are believed to be composed of fibrocalcific plaque. In this study, intracoronary near-infrared spectroscopy (NIRS) was used to determine the frequency of LCP at target and remote sites in patients with ACS versus those with stable angina. METHODS AND RESULTS: The study was performed in patients having ≥1 target lesion identified by invasive angiography who also underwent NIRS before intervention. LCP was defined as a 2-mm segment on the NIRS block chemogram having a strong positive reading indicated by a bright-yellow color. Patients with ACS and those with stable angina were compared for the frequency of LCP at target and remote sites. Among 60 patients (46.7% with ACS) undergoing invasive angiography and NIRS, 68 target lesions were identified. Although target lesions in patients with ACS were more frequently composed of LCP than targets in patients with stable angina (84.4% versus 52.8%, P=0.004), approximately one half of target lesions in patients with stable angina contained LCP. LCPs anatomically remote from the target lesion were frequent in patients with ACS and less common in patients with stable angina (73.3% versus 17.6%, P=0.002). CONCLUSIONS: Target lesions responsible for ACS were frequently composed of LCP; in addition, LCPs often were found in remote, nontarget areas. Both target and remote LCPs were more common in patients with ACS than in those with stable angina. Approximately one half of target lesions in stable patients were also composed of LCP.
BACKGROUND: Whereas acute coronary syndromes (ACS) typically develop from the rupture of lipid core plaque (LCP), lesions causing stable angina are believed to be composed of fibrocalcific plaque. In this study, intracoronary near-infrared spectroscopy (NIRS) was used to determine the frequency of LCP at target and remote sites in patients with ACS versus those with stable angina. METHODS AND RESULTS: The study was performed in patients having ≥1 target lesion identified by invasive angiography who also underwent NIRS before intervention. LCP was defined as a 2-mm segment on the NIRS block chemogram having a strong positive reading indicated by a bright-yellow color. Patients with ACS and those with stable angina were compared for the frequency of LCP at target and remote sites. Among 60 patients (46.7% with ACS) undergoing invasive angiography and NIRS, 68 target lesions were identified. Although target lesions in patients with ACS were more frequently composed of LCP than targets in patients with stable angina (84.4% versus 52.8%, P=0.004), approximately one half of target lesions in patients with stable angina contained LCP. LCPs anatomically remote from the target lesion were frequent in patients with ACS and less common in patients with stable angina (73.3% versus 17.6%, P=0.002). CONCLUSIONS: Target lesions responsible for ACS were frequently composed of LCP; in addition, LCPs often were found in remote, nontarget areas. Both target and remote LCPs were more common in patients with ACS than in those with stable angina. Approximately one half of target lesions in stable patients were also composed of LCP.
Authors: Tomotaka Dohi; Akiko Maehara; Pedro R Moreno; Usman Baber; Jason C Kovacic; Atul M Limaye; Ziad A Ali; Joseph M Sweeny; Roxana Mehran; George D Dangas; Ke Xu; Samin K Sharma; Gary S Mintz; Annapoorna S Kini Journal: Eur Heart J Cardiovasc Imaging Date: 2014-09-04 Impact factor: 6.875
Authors: Jacob C Townsend; Daniel H Steinberg; Christopher D Nielsen; Thomas M Todoran; Chetan P Patel; Robert A Leonardi; Bethany J Wolf; Emmanouil S Brilakis; Kendrick A Shunk; James A Goldstein; Morton J Kern; Eric R Powers Journal: Am J Cardiol Date: 2013-04-30 Impact factor: 2.778
Authors: Kohei Takata; Satoshi Honda; Samuel L Sidharta; MyNgan Duong; Daisuke Shishikura; Susan W Kim; Jordan Andrews; Belinda A Di Bartolo; Peter J Psaltis; Christina A Bursill; Matthew I Worthley; Stephen J Nicholls Journal: Cardiovasc Diagn Ther Date: 2019-08
Authors: Tomasz Roleder; Keyvan Karimi Galougahi; Chee Yang Chin; Navdeep K Bhatti; Emmanouil Brilakis; Tamim M Nazif; Ajay J Kirtane; Dimitri Karmpaliotis; Wojciech Wojakowski; Martin B Leon; Gary S Mintz; Akiko Maehara; Gregg W Stone; Ziad A Ali Journal: Eur Heart J Cardiovasc Imaging Date: 2017-06-01 Impact factor: 6.875