Lipid Rich Necrotic Core Lesion Detected by Cardiac Magnetic Resonance Imaging (CMR)

Inclusion Criteria: * Age 18 to 90 years * Patients with known obstrucive coronary arterial disease for PCI in a native coronary artery * Ability and willingness to consent and Authorization for use of personal health information (PHI) * Ability and willingness to the required follow up procedures Exclusion Criteria: * An acute myocardial infarction in the vascular territory of interest. * History of percutaneous coronary intervention in the major epicardial vessel of interest * Lesion characteristics that preclude IVUS * The presence of delayed enhancement in the territory of the study vessel on baseline CMR * Patients with current history of cardiomyopathy which is known to cause enhancement on CMR study * Patients who are considered hemodynamically unstable based on clinical assessment by the physician * Patients with Class IV congestive heart failure at time of enrollment * Patients with poorly controlled hypertension with SBP \>/= 210mmhg and/or DBP \>/=140 hypertension unable to be treated, at time of enrollment * GFR\</=30 pre-procedure per institutional standards * Patients with any known co-morbid conditions that is limiting their life expectancy to \< 1year * A known contraindication to Adenosine, including but not limited to: * Moderate to severe hyperactive airway disease such as asthma and severe COPD * Second or third degree AV block * Known sinus node disease, such as sick sinus syndrome or symptomatic bradycardia * Known hypersensitivity to Adenosine * A known contraindication to MRI * Electronically, magnetically, and mechanically activated implants * Ferromagnetic or electronically operated active devices like automatic cardioverter defibrillators, and cardiac pacemakers * Metallic splinters/fragments in sensitive tissues including the eye, brain, spinal cord etc… * Ferromagnetic haemostatic clips in the central nervous system * A known contraindication to Gadolinium * Patients with history of allergic reactions to gadolinium based contrast * Patients with glomerular filtration rate (GFR) \</= 30ml/min * Inability or unwillingness to consent and Authorization for use of PHI * Patients who are unwilling or unable to follow up * Known pregnancy