Near-infrared spectroscopy for the detection of lipid core coronary plaques

Lipid core coronary plaques (LCPs), which cannot be reliably detected by conventional diagnostic measures, are widely considered to be the cause of most acute coronary syndromes. Accumulating evidence also indicates that LCPs may increase the risk of stenting complications. A catheter-based near-infrared spectroscopy (NIRS) system is now available for the detection of LCPs in the arteries of patients undergoing coronary angiography. The system, which uses the well-documented ability of NIRS to determine the chemical composition of unknown substances, has been validated in an autopsy study and a clinical trial. The system has now been used in more than 300 patients and has provided novel information for use in assessment of coronary disease. Multiple studies are in progress to assess the full clinical benefit of NIRS for the goals of 1) improving the safety of stenting, 2) preventing a second coronary event in patients with known coronary disease, and 3) use as a possible component in a strategy for the primary prevention of coronary events.