Comparison of Coronary Plaque Components between Non-Culprit Lesions in Patients with Acute Coronary Syndrome and Target Lesions in Patients with Stable Angina: Virtual Histology-Intravascular Ultrasound Analysis
Korean Circulation Journal
;
: 607-614, 2013.
Article
in English
| WPRIM
| ID: wpr-78986
ABSTRACT
BACKGROUND AND OBJECTIVES:
The differences in plaque characteristics between non-culprit lesions (NCL) in acute coronary syndrome (ACS) patients (ACS-NCL) and target lesions (TL) in stable angina (SA) patients (SA-TL) are not well understood. We used a virtual histology-intravascular ultrasound (VH-IVUS) to compare the plaque components between ACS-NCL and SA-TL. SUBJECTS ANDMETHODS:
We compared VH-IVUS findings between 290 ACS-NCL and 276 SA-TL. VH-IVUS classified the color-coded tissue into four major components green (fibrotic); yellow-green (fibro-fatty); white {dense calcium (DC)}; and red {necrotic core (NC)}. Thin-cap fibroatheroma (TCFA) was defined as a NC > or =10% of the plaque area in at least 3 consecutive frames without overlying fibrous tissue in the presence of > or =40% plaque burden.RESULTS:
Although the plaque burden was significantly smaller (52+/-13% vs. 54+/-14%, p=0.044), ACS-NCL had a greater %NC area (17.9+/-11.6% vs. 14.3+/-8.7%, p<0.001) and %DC area (9.7+/-9.8% vs. 8.1+/-8.0%, p=0.032) compared with SA-TL at the minimum lumen site. By volumetric analysis, ACS-NCL had a greater %NC volume (15.8+/-9.2% vs. 13.9+/-7.4%, p=0.006) compared with SA-TL. TCFA was observed more frequently in ACS-NCL compared with SA-TL (27.6% vs. 18.1%, p=0.032). Independent predictors of TCFA by multivariate analysis were ACS {odds ratio (OR) 2.204, 95% CI 1.321-3.434, p=0.021} and high-sensitivity C-reactive protein (OR 1.101; 95% CI 1.058-1.204, p=0.035).CONCLUSION:
Although the plaque burden was significantly smaller, ACL-NCL had more vulnerable plaque components compared with SA-TL, and ACS and high-sensitivity C-reactive protein were the independent predictors of TCFA.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
C-Reactive Protein
/
Calcium
/
Multivariate Analysis
/
Ultrasonography, Interventional
/
Acute Coronary Syndrome
/
Plaque, Atherosclerotic
/
Angina, Stable
Type of study:
Prognostic study
Limits:
Humans
Language:
English
Journal:
Korean Circulation Journal
Year:
2013
Type:
Article
Similar
MEDLINE
...
LILACS
LIS