OBJECTIVEThe purpose of the present study was to compare the plaque composition between patients with acute coronary syndrome (ACS) and stable coronary artery disease (SCAD) by intravascular ultrasound virtual histological analysis.

METHODSTwo hundred and ten patients were divided into ACS group (n = 131, 188 diseased vessels) and SCAD group (n = 79, 158 diseased vessels). A total of 346 de novo lesions with > 50% stenosis in native coronary arteries with diameters > 2.5 mm were studied with intravascular ultrasonography. Geometric and compositional data were obtained using intravascular ultrasound virtual histology software.

RESULTSThere were no significant differences in overall lesions for fibrous (51.2% +/- 12.5% vs. 52.6% +/- 9.6%), fibrolipidic (11.3% +/- 10.6% vs. 12.9% +/- 9.4%), calcium (15.1% +/- 8.9% vs. 20.5% +/- 12.5%) or necrotic core (23.1% +/- 9.8% vs. 20.4% +/- 6.8%, all P > 0.05) components between ACS and SCAD patients. Culprit lesions for fibrous (49.1% +/- 11.2% vs. 50.3% +/- 9.7%), fibrolipidic (10.2% +/- 9.5% vs. 12.7% +/- 9.5%), calcium (15.4% +/- 8.9% vs. 17.4% +/- 24.8%), or necrotic core (24.0% +/- 11.5% vs. 19.7% +/- 5.3%, all P > 0.05) components were also similar between ACS and SCAD patients. High density lipoprotein-cholesterol (HDL) levels > 1.04 mmol/L was associated with more fibrolipidic (15.6% +/- 9.6% vs. 7.4% +/- 5.9%) and less necrotic core (19.4% +/- 8.6% vs. 28.6% +/- 11.2%, all P < 0.05 vs. patients with HDL < or = 1.04 mmol/L) components in ACS patients.

CONCLUSIONCoronary plaque composition was similar between ACS and SCAD patients.