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Detection by near-infrared spectroscopy of large lipid cores at culprit sites in patients with non-st-segment elevation myocardial infarction and unstable angina

Madder, Ryan D.; Husaini, Mustafa; Davis, Alan T.; VanOosterhout, Stacie; Harnek, Jan LU ; Götberg, Matthias LU and Erlinge, David LU (2015) In Catheterization and Cardiovascular Interventions 86(6). p.1014-1021
Abstract
ObjectiveThis study was performed to assess the lipid burden of culprit lesions in non-ST-segment elevation myocardial infarction (non-STEMI) and unstable angina (UA). BackgroundA 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. MethodsWe 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.... (More)
ObjectiveThis study was performed to assess the lipid burden of culprit lesions in non-ST-segment elevation myocardial infarction (non-STEMI) and unstable angina (UA). BackgroundA 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. MethodsWe 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. ResultsAmong 81 patients (53.1% non-STEMI, 46.9% UA), non-STEMI culprit segments had a 3.4-fold greater maxLCBI(4mm) than nonculprits (448229 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. ConclusionsLarge 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. (c) 2014 Wiley Periodicals, Inc. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
acute coronary syndrome, lipid core plaque, near-infrared spectroscopy
in
Catheterization and Cardiovascular Interventions
volume
86
issue
6
pages
1014 - 1021
publisher
Wiley-Blackwell
external identifiers
  • wos:000364650800017
  • scopus:84946545719
ISSN
1522-1946
DOI
10.1002/ccd.25754
language
English
LU publication?
yes
id
49d35fba-bde9-4dbc-b53b-d9130dda8eb0 (old id 8377511)
date added to LUP
2015-12-18 08:28:33
date last changed
2017-11-19 04:01:45
@article{49d35fba-bde9-4dbc-b53b-d9130dda8eb0,
  abstract     = {ObjectiveThis study was performed to assess the lipid burden of culprit lesions in non-ST-segment elevation myocardial infarction (non-STEMI) and unstable angina (UA). BackgroundA 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. MethodsWe 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. ResultsAmong 81 patients (53.1% non-STEMI, 46.9% UA), non-STEMI culprit segments had a 3.4-fold greater maxLCBI(4mm) than nonculprits (448229 vs 132 +/- 154, P&lt;0.001) and UA culprit segments had a 2.6-fold higher maxLCBI(4mm) than nonculprits (381 +/- 239 vs 146 +/- 175, P&lt;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. ConclusionsLarge 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. (c) 2014 Wiley Periodicals, Inc.},
  author       = {Madder, Ryan D. and Husaini, Mustafa and Davis, Alan T. and VanOosterhout, Stacie and Harnek, Jan and Götberg, Matthias and Erlinge, David},
  issn         = {1522-1946},
  keyword      = {acute coronary syndrome,lipid core plaque,near-infrared spectroscopy},
  language     = {eng},
  number       = {6},
  pages        = {1014--1021},
  publisher    = {Wiley-Blackwell},
  series       = {Catheterization and Cardiovascular Interventions},
  title        = {Detection by near-infrared spectroscopy of large lipid cores at culprit sites in patients with non-st-segment elevation myocardial infarction and unstable angina},
  url          = {http://dx.doi.org/10.1002/ccd.25754},
  volume       = {86},
  year         = {2015},
}