Document Detail

Detection by near-infrared spectroscopy of large lipid cores at culprit sites in patients with non-ST-segment elevation myocardial infarction and unstable angina.
MedLine Citation:
PMID:  25418711     Owner:  NLM     Status:  Publisher    
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 (maxLCBI4mm ) ≥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 non-overlapping 10-mm non-culprit segments for maxLCBI4mm . Culprit segments in non-STEMI and UA were compared for the frequency of maxLCBI4mm ≥400. Results: Among 81 patients (53.1% non-STEMI, 46.9% UA), non-STEMI culprit segments had a 3.4-fold greater maxLCBI4mm than non-culprits (448±229 vs 132±154, p<0.001) and UA culprit segments had a 2.6-fold higher maxLCBI4mm than non-culprits (381±239 vs 146±175, p<0.001). NIRS detected a maxLCBI4mm ≥400in 63.6% of culprit segments in NSTEMI and in 38.5% of culprit segments in unstable angina (p=0.02). Against a background of non-culprit segments, maxLCBI4mm ≥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. This article is protected by copyright. All rights reserved.
Ryan D Madder; Mustafa Husaini; Alan T Davis; Stacie VanOosterhout; Jan Harnek; Matthias Götberg; David Erlinge
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-22
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  -     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-11-24     Completed Date:  -     Revised Date:  2014-11-25    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2014 Wiley Periodicals, Inc.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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