期刊
JACC-CARDIOVASCULAR INTERVENTIONS
卷 6, 期 8, 页码 838-846出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jcin.2013.04.012
关键词
myocardial infarction; near-infrared spectroscopy; vulnerable plaque
资金
- St. Jude Medical
- Infraredx
- Guerbet
- Gilead
- Abbott Vascular
- Siemens Medical Systems
- AstraZeneca
- Resverlogix
- Eli Lilly
- Novartis
- Anthera
- Roche
- Merck
- Takeda
- Omthera
- CSL Behring
- Boehringer Ingelheim
- Boston Scientific Corporation
- Volcano
- Boston Scientific
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 preexisting 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 MaxLCBI(4mm) 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 maxLCBI(4mm) >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 maxLCBI(4mm) >400, as detected by NIRS, is a signature of plaques causing STEMI. (C) 2013 by the American College of Cardiology Foundation
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据