Longitudinal Distribution of Lipid-Rich Plaque in Nonculprit Lesions: A Lipid Rich Plaque Study Subanalysis

Previous studies have shown that proximal lesions are associated with more events than nonproximal lesions whether assessed angiographically (acute occlusions), grayscale or virtual histology intravascular ultrasound (IVUS) (which may find plaque ruptures or thin-cap fibroatheromas [TCFAs]), or optical coherence tomography (which may find TCFAs, plaque ruptures, or erosions) (1, 2, 3). Whether these findings hold when assessing arterial-wall lipid content using near-infrared spectroscopy (NIRS: maximal lipid core burden index in any 4-mm segment [maxLCBI4mm]) is unknown. In the LRP (Lipid Rich Plaque) study, lipid-rich plaques (maxLCBI4mm >400) were associated with a greater incidence of nonculprit-major adverse cardiovascular events (NC-MACE) (4). The current substudy analyzed LRP patients to determine proximal versus non proximal LRP distribution and the impact of plaque location on NC-MACE.