Ryan D Madder1, Mustafa Husaini1, Alan T Davis2,3, Stacie VanOosterhout1, Jan Harnek4, Matthias Götberg4, David Erlinge4. 1. Frederik Meijer Heart & Vascular Institute, Spectrum Health, Grand Rapids, Michigan. 2. Department of Surgery, Michigan State University, Lansing, Michigan. 3. Research Department, Grand Rapids Medical Education Partners, Grand Rapids, Michigan. 4. Department of Cardiology, Lund University, Lund, Sweden.
Abstract
OBJECTIVE: This study was performed to assess the lipid burden of culprit lesions in non-ST-segment elevation myocardial infarction (non-STEMI) and unstable angina (UA). BACKGROUND: A recent intracoronary near-infrared spectroscopy (NIRS) study showed 85% of STEMI culprit lesions have a maximum lipid core burden index in 4-mm (maxLCBI(4mm)) ≥ 400. Whether culprit lesions in non-STEMI and UA are characterized by a similarly large lipid burden is unknown. METHODS: We studied 81 non-STEMI and UA patients undergoing culprit vessel NIRS imaging before stenting. Culprit segments were compared to all nonoverlapping 10-mm nonculprit segments for maxLCBI(4mm). Culprit segments in non-STEMI and UA were compared for the frequency of maxLCBI(4mm) ≥ 400. RESULTS: Among 81 patients (53.1% non-STEMI, 46.9% UA), non-STEMI culprit segments had a 3.4-fold greater maxLCBI(4mm) than nonculprits (448 ± 229 vs 132 ± 154, P < 0.001) and UA culprit segments had a 2.6-fold higher maxLCBI(4mm) than nonculprits (381 ± 239 vs 146 ± 175, P < 0.001). NIRS detected a maxLCBI(4mm) ≥ 400 in 63.6% of culprit segments in NSTEMI and in 38.5% of culprit segments in UA (P = 0.02). Against a background of nonculprit segments, maxLCBI(4mm) ≥ 400 had a sensitivity of 63.6% and specificity of 94.0% for culprit segments in NSTEMI and a sensitivity of 38.5% and specificity of 89.8% for culprit segments in UA. CONCLUSIONS: Large lipid cores similar to those recently detected by NIRS at STEMI culprit sites were frequently observed at culprit sites in patients with non-STEMI and UA. These findings support ongoing prospective trials designed to determine if NIRS can provide site-specific prediction of future acute coronary events.
OBJECTIVE: This study was performed to assess the lipid burden of culprit lesions in non-ST-segment elevation myocardial infarction (non-STEMI) and unstable angina (UA). BACKGROUND: A recent intracoronary near-infrared spectroscopy (NIRS) study showed 85% of STEMI culprit lesions have a maximum lipid core burden index in 4-mm (maxLCBI(4mm)) ≥ 400. Whether culprit lesions in non-STEMI and UA are characterized by a similarly large lipid burden is unknown. METHODS: We studied 81 non-STEMI and UA patients undergoing culprit vessel NIRS imaging before stenting. Culprit segments were compared to all nonoverlapping 10-mm nonculprit segments for maxLCBI(4mm). Culprit segments in non-STEMI and UA were compared for the frequency of maxLCBI(4mm) ≥ 400. RESULTS: Among 81 patients (53.1% non-STEMI, 46.9% UA), non-STEMI culprit segments had a 3.4-fold greater maxLCBI(4mm) than nonculprits (448 ± 229 vs 132 ± 154, P < 0.001) and UA culprit segments had a 2.6-fold higher maxLCBI(4mm) than nonculprits (381 ± 239 vs 146 ± 175, P < 0.001). NIRS detected a maxLCBI(4mm) ≥ 400 in 63.6% of culprit segments in NSTEMI and in 38.5% of culprit segments in UA (P = 0.02). Against a background of nonculprit segments, maxLCBI(4mm) ≥ 400 had a sensitivity of 63.6% and specificity of 94.0% for culprit segments in NSTEMI and a sensitivity of 38.5% and specificity of 89.8% for culprit segments in UA. CONCLUSIONS: Large lipid cores similar to those recently detected by NIRS at STEMI culprit sites were frequently observed at culprit sites in patients with non-STEMI and UA. These findings support ongoing prospective trials designed to determine if NIRS can provide site-specific prediction of future acute coronary events.
Authors: Christos V Bourantas; Farouc A Jaffer; Frank J Gijsen; Gijs van Soest; Sean P Madden; Brian K Courtney; Ali M Fard; Erhan Tenekecioglu; Yaping Zeng; Antonius F W van der Steen; Stanislav Emelianov; James Muller; Peter H Stone; Laura Marcu; Guillermo J Tearney; Patrick W Serruys Journal: Eur Heart J Date: 2017-02-07 Impact factor: 29.983
Authors: Anubodh S Varshney; Ahmet U Coskun; Gerasimos Siasos; Charles C Maynard; Zhongyue Pu; Kevin J Croce; Nicholas V Cefalo; Michelle A Cormier; Dimitris Fotiadis; Kostas Stefanou; Michail I Papafaklis; Lampros Michalis; Stacie VanOosterhout; Abbey Mulder; Ryan D Madder; Peter H Stone Journal: Atherosclerosis Date: 2020-12-28 Impact factor: 5.162
Authors: Victor J van den Berg; Dorian O Haskard; Artur Fedorowski; Adam Hartley; Isabella Kardys; Mikhail Caga-Anan; K Martijn Akkerhuis; Rohit M Oemrawsingh; Robert Jan van Geuns; Peter de Jaegere; Nicolas van Mieghem; Evelyn Regar; Jurgen M R Ligthart; Victor A W M Umans; Patrick W Serruys; Olle Melander; Eric Boersma; Ramzi Y Khamis Journal: EBioMedicine Date: 2018-08-18 Impact factor: 8.143