ABSTRACT
AIM: to compare noninfarct-related lesions in patients with acute myocardial infarction (MI) with culprit and non-culprit lesions in patients with stable angina pectoris (SAP) using intravascular ultrasound virtual histology (VH-IVUS). MATERIAL AND METHODS: Overall 70 patients were enrolled: 38 with ST elevation (STE) MI and 32 with stable angina pectoris (SAP). All patients underwent three-vessel coronary angiography and gray-scale and VH-IVUS after percutaneous coronary intervention (PCI) of infarct-related lesion in STEMI or culprit lesion in SAP. RESULTS: A total of 130 plaques were examined: 70 in patients with STEMI and 60 in patients with SAP. Noninfarct-related lesions in acute MI compared with non-culprit lesions in SAP had significantly larger plaque burden and plaque volume, smaller minimum lumen area, and more positive remodeling. STEMI, hyperlipidemia, plaque burden, and hypertension were independent predictors of unstable plaques.
Subject(s)
Angina, Stable/diagnostic imaging , Coronary Vessels/diagnostic imaging , Myocardial Infarction/diagnostic imaging , Plaque, Atherosclerotic/diagnostic imaging , Ultrasonography, Interventional/methods , Diagnosis, Differential , Electrocardiography , Female , Humans , Male , Middle Aged , Myocardial Infarction/surgery , Percutaneous Coronary Intervention , Reproducibility of ResultsABSTRACT
In most cases direct cause of acute coronary syndrome and sudden death is an intracoronary thrombus formed on a surface of unstable atherosclerotic plaque (UAP). The following are main characteristics of UAP: active inflammation; large lipid rich nucleus occupying a40% of plaque volume; thin (< 65 mm) fibrous cap; erosions of intima over plaque; tear of plaque cap; superficially located calcium nodules; intraplaque hemorrhage. Visualization of UAP in coronary arteries is a very important direction in diagnostics. During recent years both invasive and noninvasive methods of detection of UAP have been actively developed. In this review we present main noninvasive techniques used for detection of UAP: multislice computed tomography, magnetic resonance tomography, positron emission tomography and single-photon emission computed tomography. In the review we have covered main advantages and limitations of each invasive method of UAP detection and delineated perspectives of development of this direction.
Subject(s)
Acute Coronary Syndrome/diagnosis , Diagnostic Imaging/methods , Plaque, Atherosclerotic/diagnosis , Acute Coronary Syndrome/etiology , Humans , Multidetector Computed Tomography , Plaque, Atherosclerotic/complications , Positron-Emission Tomography , Tomography, Emission-Computed, Single-PhotonABSTRACT
AIM: to compare noninfarct-related lesions in patients with acute myocardial infarction (MI) with culprit and non-culprit lesions in patients with stable angina pectoris (SAP) using intravascular ultrasound virtual histology (VH-IVUS). MATERIAL AND METHODS: Overall 70 patients were enrolled: 38 with ST elevation (STE) MI and 32 with stable angina pectoris (SAP). All patients underwent three-vessel coronary angiography and gray-scale and VH-IVUS after percutaneous coronary intervention (PCI) of infarct-related lesion in STEMI or culprit lesion in SAP.
