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Confirmation of the Intracoronary Near-Infrared Spectroscopy Threshold of Lipid-Rich Plaques That Underlie ST-Segment-Elevation Myocardial Infarction.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Madder, Ryan D. Puri, Rishi Kumar Muller, James E. Harnek, Jan Götberg, Matthias Vanoosterhout, Stacie M. Chi, Margaret Wohns, David H. W. かおる, 小野 Wolski, Kathy E. Madden, Sean Patrick Sidharta, Samuel L. Andrews, Jordan Nicholls, Stephen J. Erlinge, David |
| Copyright Year | 2016 |
| Abstract | OBJECTIVE In a previous exploratory analysis, intracoronary near-infrared spectroscopy (NIRS) found the majority of culprit lesions in ST-segment-elevation myocardial infarction (STEMI) to contain a maximum lipid core burden index in 4 mm (maxLCBI4mm) of >400. This initial study was limited by a small sample size, enrollment at a single center, and post hoc selection of the maxLCBI4mm ≥400 threshold. This study was designed a priori to substantiate the ability of NIRS to discriminate STEMI culprit from nonculprit segments and to confirm the performance of the maxLCBI4mm ≥400 threshold. APPROACH AND RESULTS At 2 centers in the United States and Sweden, 75 STEMI patients underwent intracoronary NIRS imaging after establishing thrombolysis in myocardial infarction 3 flow, but before stenting. Blinded core laboratory analysis defined the culprit segment as the 10-mm segment distal to the proximal angiographic culprit margin. The remaining vessel was divided into contiguous 10-mm nonculprit segments. The maxLCBI4mm of culprit segments (median [interquartile range]: 543 [273-756]) was 4.4-fold greater than nonculprit segments (median [interquartile range]: 123 [0-307]; P<0.001). Receiver-operating characteristic analysis demonstrated that maxLCBI4mm differentiated culprit from nonculprit segments with high accuracy (c-statistic=0.83; P<0.001). A threshold maxLCBI4mm ≥400 identified STEMI culprit segments with a sensitivity of 64% and specificity of 85%. CONCLUSIONS This study substantiates the ability of NIRS to accurately differentiate STEMI culprit from nonculprit segments and confirms that a threshold maxLCBI4mm ≥400 is detected by NIRS in the majority of STEMI culprits. |
| Starting Page | 101 |
| Ending Page | 102 |
| Page Count | 2 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://atvb.ahajournals.org/content/atvbaha/36/5/1010.full.pdf?download=true |
| PubMed reference number | 26941016v1 |
| Alternate Webpage(s) | https://doi.org/10.1161/ATVBAHA.115.306849 |
| DOI | 10.1161/atvbaha.115.306849 |
| Journal | Arteriosclerosis, thrombosis, and vascular biology |
| Volume Number | 36 |
| Issue Number | 5 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Blood Vessel Tissue Cardiomyopathies Patients ST segment elevation myocardial infarction Senile Plaques Spectroscopy, Near-Infrared Thrombolysis, function X-Ray Emission Spectroscopy |
| Content Type | Text |
| Resource Type | Article |
