OBJECTIVES: This study sought to describe near-infrared spectroscopy (NIRS) findings of culprit lesions in ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Although autopsy studies demonstrate that most STEMI are caused by rupture of pre-existing lipid core plaque (LCP), it has not been possible to identify LCP in vivo. A novel intracoronary NIRS catheter has made it possible to detect LCP in patients. METHODS: We performed NIRS within the culprit vessels of 20 patients with acute STEMI and compared the STEMI culprit findings to findings in nonculprit segments of the artery and to findings in autopsy control segments. Culprit and control segments were analyzed for the maximum lipid core burden index in a 4-mm length of artery (maxLCBI(4mm)). RESULTS: MaxLCBI(4mm) was 5.8-fold higher in STEMI culprit segments than in 87 nonculprit segments of the STEMI culprit vessel (median [interquartile range (IQR)]: 523 [445 to 821] vs. 90 [6 to 265]; p < 0.001) and 87-fold higher than in 279 coronary autopsy segments free of large LCP by histology (median [IQR]: 523 [445 to 821] vs. 6 [0 to 88]; p < 0.001).Within the STEMI culprit artery, NIRS accurately distinguished culprit from nonculprit segments (receiver-operating characteristic analysis area under the curve = 0.90). A threshold of maxLCBI(4mm) >400 distinguished STEMI culprit segments from specimens free of large LCP by histology (sensitivity: 85%, specificity: 98%). CONCLUSIONS: The present study has demonstrated in vivo that a maxLCBI(4mm) >400, as detected by NIRS, is a signature of plaques causing STEMI.
OBJECTIVES: This study sought to describe near-infrared spectroscopy (NIRS) findings of culprit lesions in ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Although autopsy studies demonstrate that most STEMI are caused by rupture of pre-existing lipid core plaque (LCP), it has not been possible to identify LCP in vivo. A novel intracoronary NIRS catheter has made it possible to detect LCP in patients. METHODS: We performed NIRS within the culprit vessels of 20 patients with acute STEMI and compared the STEMI culprit findings to findings in nonculprit segments of the artery and to findings in autopsy control segments. Culprit and control segments were analyzed for the maximum lipid core burden index in a 4-mm length of artery (maxLCBI(4mm)). RESULTS: MaxLCBI(4mm) was 5.8-fold higher in STEMI culprit segments than in 87 nonculprit segments of the STEMI culprit vessel (median [interquartile range (IQR)]: 523 [445 to 821] vs. 90 [6 to 265]; p < 0.001) and 87-fold higher than in 279 coronary autopsy segments free of large LCP by histology (median [IQR]: 523 [445 to 821] vs. 6 [0 to 88]; p < 0.001).Within the STEMI culprit artery, NIRS accurately distinguished culprit from nonculprit segments (receiver-operating characteristic analysis area under the curve = 0.90). A threshold of maxLCBI(4mm) >400 distinguished STEMI culprit segments from specimens free of large LCP by histology (sensitivity: 85%, specificity: 98%). CONCLUSIONS: The present study has demonstrated in vivo that a maxLCBI(4mm) >400, as detected by NIRS, is a signature of plaques causing STEMI.
Authors: Charis Costopoulos; Adam J Brown; Zhongzhao Teng; Stephen P Hoole; Nick E J West; Habib Samady; Martin R Bennett Journal: Int J Cardiovasc Imaging Date: 2015-07-08 Impact factor: 2.357
Authors: Bo Zheng; Akiko Maehara; Gary S Mintz; Tamim M Nazif; Yarden Waksman; Fuyu Qiu; Luz Jaquez; LeRoy E Rabbani; Mark A Apfelbaum; Ziad A Ali; Kate Dalton; Lei Song; Ke Xu; Charles C Marboe; Donna M Mancini; Giora Weisz Journal: Int J Cardiovasc Imaging Date: 2015-09-25 Impact factor: 2.357
Authors: Muhammad Hammadah; Mohammed Qintar; Steven E Nissen; Julie St John; Saqer Alkharabsheh; Motunrayo Mobolaji-Lawal; Femi Philip; Kiyoko Uno; Yu Kataoka; Brett Babb; Roman Poliszczuk; Samir R Kapadia; E Murat Tuzcu; Paul Schoenhagen; Stephen J Nicholls; Rishi Puri Journal: Int J Cardiovasc Imaging Date: 2015-05-12 Impact factor: 2.357