@article{69c19e96b3d947f3843dd6fe832bc8b9,
title = "Detection by near-infrared spectroscopy of large lipid core plaques at culprit sites in patients with acute st-segment elevation myocardial infarction",
abstract = "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 MaxLCBI4mm 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 maxLCBI4mm >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 maxLCBI4mm >400, as detected by NIRS, is a signature of plaques causing STEMI.",
keywords = "myocardial infarction near-infrared spectroscopy vulnerable plaque",
author = "Madder, {Ryan D.} and Goldstein, {James A.} and Madden, {Sean P.} and Rishi Puri and Kathy Wolski and Michael Hendricks and Sum, {Stephen T.} and Annapoorna Kini and Samin Sharma and David Rizik and Brilakis, {Emmanouil S.} and Shunk, {Kendrick A.} and John Petersen and Giora Weisz and Renu Virmani and Nicholls, {Stephen J.} and Akiko Maehara and Mintz, {Gary S.} and Stone, {Gregg W.} and Muller, {James E.}",
note = "Funding Information: Dr. Madder has received speaker honoraria from Infraredx and consulting fees from St. Jude Medical. Dr. Madden, Mr. Hendricks, and Dr. Sum are employees of Infraredx, the company that developed the NIRS-IVUS instrument. Dr. Goldstein has received consulting fees from and has stock ownership in Infraredx. Dr. Kini has received research grant support from Infraredx and honoraria from Medscape and St. Jude Medical. Dr. Sharma has served on the Speakers' Bureaus of Abbott Vascular, Boston Scientific Corporation, DSI/Lilly, The Medicine Co., and Angioscore; and has received research grant support from Infraredx. Dr Sharma is affiliated with Abbott Vascular. Dr. Rizik has received research grant support from Infraredx . Dr. Brilakis has received honoraria from Bridgepoint Medical, St. Jude Medical, and Terumo; has received a research grant from Guerbet and Infraredx; and his spouse is an employee of Medtronic. Dr. Shunk has received research grants from Infraredx, Gilead, Abbott Vascular, and Siemens Medical Systems ; and is a principal partner in Revascular Therapeutics. Dr. Weisz has received consulting fees from Infraredx. Dr. Petersen has received research grant support from Infraredx . Dr. Nicholls has received research support from Infraredx, AstraZeneca, Resverlogix, Eli Lilly, Novartis, Anthera, and Roche ; and consulting fees from Merck, AstraZeneca, Takeda, Roche, Omthera, CSL Behring, and Boehringer Ingelheim. Dr. Maehara has received speakers' fees from St. Jude Medical; and a research grant from Boston Scientific Corporation and Infraredx . Dr. Mintz has received grant support from Infraredx ; and grant support and honoraria from Volcano, Boston Scientific, and St. Jude Medical . Dr. Stone has received consulting fees from Infraredx. Dr. Muller is an employee of, with stock ownership in, Infraredx, the company that developed the NIRS-IVUS instrument. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. ",
year = "2013",
month = aug,
doi = "10.1016/j.jcin.2013.04.012",
language = "English (US)",
volume = "6",
pages = "838--846",
journal = "JACC: Cardiovascular Interventions",
issn = "1936-8798",
publisher = "Elsevier Inc.",
number = "8",
}