1.Relation between Anemia and Vulnerable Coronary Plaque Components in Patients with Acute Coronary Syndrome: Virtual Histology-Intravascular Ultrasound Analysis.
Young Joon HONG ; Myung Ho JEONG ; Yun Ha CHOI ; Jin A SONG ; Dong Han KIM ; Ki Hong LEE ; Futoshi YAMANAKA ; Min Goo 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
Journal of Korean Medical Science 2012;27(4):370-376
The aim of the present study was to evaluate the plaque components and the predictors of thin-cap fibroatheroma (TCFA) in anemic patients with acute coronary syndrome using virtual histology-intravascular ultrasound (VH-IVUS). Anemia was defined according to criteria of the World Health Organization, (i.e. , hemoglobin levels < 13 g/dL in men and < 12 g/dL in women) and we compared VH-IVUS findings between anemia group (171 patients, 260 lesions) and non-anemia group (569 patients, 881 lesions). Anemia group had greater % necrotic core (NC) volume (21% +/- 9% vs 19% +/- 9%, P = 0.001) compared with non-anemia group. Hemoglobin level correlated negatively with absolute NC volume (r = -0.235, P < 0.001) and %NC volume (r = -0.209, P < 0.001). Independent predictors of TCFA by multivariate analysis were diabetes mellitus (odds ratio [OR], 2.213; 95% confidence interval [CI], 1.403-3.612, P = 0.006), high-sensitivity C-reactive protein (OR, 1.143; 95% CI, 1.058-1.304, P = 0.012), microalbuminuria (albumin levels of 30 to 300 mg/g of creatinine) (OR, 2.124; 95% CI, 1.041-3.214, P = 0.018), and anemia (OR: 2.112; 95% CI 1.022-3.208, P = 0.028). VH-IVUS analysis demonstrates that anemia at the time of clinical presentation is associated with vulnerable plaque component in patients with acute coronary syndrome.
Acute Coronary Syndrome/complications/*pathology/ultrasonography
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Aged
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Albuminuria/urine
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Anemia/complications/*diagnosis
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C-Reactive Protein/analysis
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Coronary Angiography
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Creatinine/blood
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Diabetes Complications
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Female
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Hemoglobins/analysis
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Humans
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Male
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Middle Aged
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Necrosis/pathology
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Odds Ratio
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Plaque, Atherosclerotic/*ultrasonography
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Predictive Value of Tests
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*Ultrasonography, Interventional