title: Lipid-core burden response to stent implantation assessed with near-infrared spectroscopy and intravascular ultrasound evaluation in patients with myocardial infarction.
abstract: BACKGROUND
  Near-infrared spectroscopy (NIRS) is a new method to identify lipid core plaque (LCP). The LCP and vascular response were assessed with NIRS to examine whether LCP was compressed or redistributed during percutaneous coronary intervention with stent implantation.
  
  
  METHODS
  In 25 patients with non-ST segment elevation myocardial infarction (NSTEMI) NIRS acquisition was performed after predilation, stent implantation with nominal pressure and high-pressure post-dilation with a non-compliant balloon. The intravascular ultrasound (IVUS) measures included volumes of external elastic membrane (EEM), lumen and plaque+media. The NIRS measures included lipid core burden index (LCBI) and maximum value of LCBI for any of the 4-mm segment (maxLCBI4mm).
  
  
  RESULTS
  From predilation to stent implantation and post-dilation EEM volume increased from 337±124mm3to 369±136mm3and to 397±144mm3(p<0.001), while plaque volume decreased from 225±84mm3to 202±85mm3and to 192±81mm3(p<0.001). Plaque shift to the proximal reference segment was found in 40% of the lesions. The maxLCBI4mmdecreased significantly from predilation to stent implantation (492±235 to 208±193 (p<0.001), whereas post dilation did not cause any further significant reduction. Also LCBI decreased significantly from predilation to stent implantation (173±103 to 68±67, p<0.001), without any further significant reduction during post-dilation. The LCBI did neither in the proximal nor in the distal reference segments change significantly during stent implantation or post-dilation.
  
  
  CONCLUSIONS
  Lumen enlargement was caused by vessel expansion, plaque compression and longitudinally plaque redistribution. Lipid-core burden at the stented segment was decreased.
authors.affiliation: Department of Cardiology, Odense University Hospital, Denmark.
authors.forename: Manijeh
authors.initials: M
authors.lastname: Noori
authors.affiliation: Department of Cardiology, Odense University Hospital, Denmark.
authors.forename: Per
authors.initials: P
authors.lastname: Thayssen
authors.affiliation: Department of Cardiology, Odense University Hospital, Denmark.
authors.forename: Karsten Tange
authors.initials: KT
authors.lastname: Veien
authors.affiliation: Department of Cardiology, Odense University Hospital, Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Junker
authors.affiliation: Department of Cardiology, Odense University Hospital, Denmark.
authors.forename: Knud Nørregaard
authors.initials: KN
authors.lastname: Hansen
authors.affiliation: Department of Cardiology, Odense University Hospital, Denmark.
authors.forename: Henrik Steen
authors.initials: HS
authors.lastname: Hansen
authors.affiliation: Department of Cardiology, Odense University Hospital, Denmark. Electronic address: okkels@dadlnet.dk.
authors.forename: Lisette Okkels
authors.initials: LO
authors.lastname: Jensen
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000737:chemistry / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D005355:Fibrosis; D006801:Humans; D008055:Lipids / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D000072658:Non-ST Elevated Myocardial Infarction / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D012422:Rupture, Spontaneous; D019265:Spectroscopy, Near-Infrared; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D008055:Lipids
keywords: Compression; Lipid-core; Near-infrared spectroscopy; Redistribution