Acute coronary syndrome may develop in the background of hemodynamically non-significant coronary artery disease. It may be caused by the presence of "vulnerable plaque", which is characterized by the lipid rich core and thin fibrous cap content. NIRS - near infrared spectroscopy - is a morphological imaging method allowing determining atherosclerotic plaque cholesterol burden. Information about the chemical composition may contribute to "high risk" plaque early identification and subsequent optimal interventional strategy. The first experience with the clinical implementation of this novel method is demonstrated in a case report. Key words: acute coronary syndrome - chemogram - intravascular imaging - NIRS - vulnerable plaque.
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