TY - JOUR
T1 - Relation between the presence and extent of coronary lipid core plaques detected by near-infrared spectroscopy with postpercutaneous coronary intervention myocardial infarction
AU - Raghunathan, Deepa
AU - Abdel-Karim, Abdul Rahman Riyad
AU - Papayannis, Aristotelis C.
AU - Dasilva, Monica
AU - Jeroudi, Omar M.
AU - Rangan, Bavana V.
AU - Banerjee, Subhash
AU - Brilakis, Emmanouil S.
N1 - Funding Information:
Dr. Banerjee has served on the speakers' bureau for St. Jude Medical, Minneapolis, Minnesota, Medtronic Corporation, Minneapolis, Minnesota, and Johnson and Johnson, Warren, New Jersey, and has received a research grant from Boston Scientific , Natick, Massachusetts. Dr. Brilakis has received speaker honoraria from St. Jude Medical, Minneapolis, Minnesota and Terumo, Somerset, New Jersey, research support from Abbott Vascular, Santa Clara, California, and InfraRedx, Burlington, Massachusetts and his spouse is an employee of Medtronic Corporation, Minneapolis, Minnesota.
PY - 2011/6/1
Y1 - 2011/6/1
N2 - We aimed to examine whether an association exists between the presence and extent of coronary lipid core plaques (LCPs) detected by near-infrared spectroscopy (NIRS) performed before percutaneous coronary intervention (PCI) with postprocedural myocardial infarction (MI). NIRS was performed in the native coronary arteries of 30 patients before PCI. Angular extent of LCP, lesion segment lipid core burden index, and block chemogram were evaluated. Cardiac biomarkers were measured before and 16 to 24 hours after PCI to determine occurrence of postprocedural MI. Mean number of 2-mm yellow blocks within the stented lesion was 1.4 ± 2.1 and mean lesion lipid core burden index was 110.3 ± 99. Using a definition of creatine kinase-MB >1 time upper limit of normal (ULN), >2 times ULN, and >3 times ULN, MI after PCI occurred in 23%, 13%, and 10% of patients, respectively. Compared to patients who did not have MI after PCI, those who did had similar clinical characteristics but received more stents and had more blocks within the stented lesion. Creatine kinase-MB increase >3 times ULN was observed in 27% of patients with <1 yellow block versus in none of the patients without a yellow block within the stented lesion (p = 0.02). In conclusion, PCI of LCP-positive lesions as assessed by NIRS is associated with increased risk for MI after PCI. NIRS may allow lesion-specific risk stratification before PCI and optimization of PCI strategies for myocardial injury risk minimization.
AB - We aimed to examine whether an association exists between the presence and extent of coronary lipid core plaques (LCPs) detected by near-infrared spectroscopy (NIRS) performed before percutaneous coronary intervention (PCI) with postprocedural myocardial infarction (MI). NIRS was performed in the native coronary arteries of 30 patients before PCI. Angular extent of LCP, lesion segment lipid core burden index, and block chemogram were evaluated. Cardiac biomarkers were measured before and 16 to 24 hours after PCI to determine occurrence of postprocedural MI. Mean number of 2-mm yellow blocks within the stented lesion was 1.4 ± 2.1 and mean lesion lipid core burden index was 110.3 ± 99. Using a definition of creatine kinase-MB >1 time upper limit of normal (ULN), >2 times ULN, and >3 times ULN, MI after PCI occurred in 23%, 13%, and 10% of patients, respectively. Compared to patients who did not have MI after PCI, those who did had similar clinical characteristics but received more stents and had more blocks within the stented lesion. Creatine kinase-MB increase >3 times ULN was observed in 27% of patients with <1 yellow block versus in none of the patients without a yellow block within the stented lesion (p = 0.02). In conclusion, PCI of LCP-positive lesions as assessed by NIRS is associated with increased risk for MI after PCI. NIRS may allow lesion-specific risk stratification before PCI and optimization of PCI strategies for myocardial injury risk minimization.
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U2 - 10.1016/j.amjcard.2011.01.044
DO - 10.1016/j.amjcard.2011.01.044
M3 - Article
C2 - 21575750
AN - SCOPUS:79956070961
SN - 0002-9149
VL - 107
SP - 1613
EP - 1618
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 11
ER -