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.
10.4070/kcj.2013.43.9.607
- Author:
Young Joon HONG
1
;
Myung Ho JEONG
;
Yun Ha CHOI
;
Soo Young PARK
;
Si Hyun RHEW
;
Hae Chang JEONG
;
Jae Yeong CHO
;
Su Young JANG
;
Ki Hong LEE
;
Keun Ho PARK
;
Doo Sun SIM
;
Nam Sik YOON
;
Hyun Ju YOON
;
Kye Hun KIM
;
Hyung Wook PARK
;
Ju Han KIM
;
Youngkeun AHN
;
Jeong Gwan CHO
;
Jong Chun PARK
;
Jung Chaee KANG
Author Information
1. Heart Center of Chonnam National University Hospital, Gwangju, Korea. myungho@chollian.net
- Publication Type:Original Article
- Keywords:
Acute coronary syndrome;
Angina, stable;
Atherosclerotic plaque;
Ultrasonography, intravascular
- MeSH:
Acute Coronary Syndrome;
Angina, Stable;
C-Reactive Protein;
Calcium;
Humans;
Multivariate Analysis;
Plaque, Atherosclerotic;
Ultrasonography, Interventional
- From:Korean Circulation Journal
2013;43(9):607-614
- CountryRepublic of Korea
- Language:English
-
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 AND METHODS: 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.
