Most studies comparing lesion characteristic of non-culprit plaques of acute coronary syndrome (ACS) patients to plaques of stable angina patients studied only in hemodynamically insignificant nonculprit plaques (eg diameter stenosis <30 or 50%). With increase in plaque burden, plaque composition might change. Lipidic content measured by near-infrared spectroscopy (NIRS) and represented by lipid core burden index (LCBI) has demonstrated its correlation with future non-culprit major adverse cardiac events. New insights in plaque composition of hemodynamically significant non-culprit

lesions may serve to understand the potential of pharmacological therapy to prevent non-culprit major adverse cardiac events.