19 Jul 2013, BioSpectrum Bureau , BioSpectrum
Singapore: Researchers at US based Spectrum Health's Frederik Meijer Heart and Vascular Institute have developed imaging technology that enables identification of the characteristic makeup, or signature, of arterial plaque blocking an artery and causing a heart attack.
Knowing what type of plaque is present in narrowed arteries may help a physician determine a patient's risk for heart attacks and may lead to novel treatment options to avoid a serious cardiac event.
Previous research during autopsies has shown that most major heart attacks called ST-segment elevation myocardial infarctions (STEMIs) are caused by the rupture of lipid core plaque (LCP), a type of plaque rich in cholesterol. However, this is the first study to document the presence of LCP in living patients. The LCP was detected with the use of near-infrared spectroscopy (NIRS) performed with a special coronary catheter.
The study used this NIRS system to measure cholesterol in the plaques of 20 patients experiencing a STEMI. The measurements were made after blood flow was reestablished but before a stent was placed to keep the artery open.
"We have discovered a NIRS signature of the plaques which caused myocardial infarction, a leading cause of death and injury worldwide," said Dr Ryan Madder, a Spectrum Health interventional cardiologist and principal investigator of the study. "This signature is detectable at the time of cardiac catheterization using a novel intracoronary imaging device. It is our hope that this signature may be capable of predicting a myocardial infarction before it happens."
Dr Madder believes that these findings provide support for further research of arteries narrowed with LCP. He's interested in conducting a prediction study to determine if patients with significant deposits of LCP do have a higher risk of heart attack. "If using NIRS technology is validated as a reliable predictor of cardiac events, then randomized studies of promising systemic and local therapies could be conducted," he added.
The system provides an image that displays key structural elements of a blockage. At the same time, the system performs spectroscopic analysis of optical data to produce a chemogram map that indicates the location of LCP and quantifies the lipid core deposit in the artery.