Document Detail

Clinical classification and plaque morphology determined by optical coherence tomography in unstable angina pectoris.
MedLine Citation:
PMID:  20643240     Owner:  NLM     Status:  MEDLINE    
Unstable angina pectoris (UAP) is categorized with the Braunwald classification. However, the association of clinical presentation and plaque structure/function has not yet been elucidated in relation to cause. We used optical coherence tomography to investigate this relation. One hundred fifteen patients with primary UAP were categorized according to the Braunwald classification. Patients with class I UAP had the highest frequency of ulcers without fibrous cap disruption (p = 0.003) and the smallest minimum lumen area (class I, median 0.70 mm(2), quartiles 1 to 3 0.42 to 1.00; class II, 1.80 mm(2), 1.50 to 2.50; class III, 2.31 mm(2), 1.21 to 3.00; p <0.001). Patients with class II UAP had the highest frequency of coronary spasm (p <0.001) and the lowest frequency of thrombi (p <0.001). Patients with class III UAP had the highest frequency of plaque ruptures (p <0.001), the thinnest fibrous cap (class I, median 140 microm, quartile 1 to 3 90 to 160; class II, 150 microm, 120 to 160; class III, 60 microm, 40 to 105; p <0.001), and the highest frequency of thin cap fibroatheromas (p <0.001) and spotty calcifications (p <0.001). In conclusion, the structures/functions of culprit lesions on optical coherence tomograms differ in the Braunwald classes of UAP. Plaque vulnerability, progressive stenosis, and vasoconstriction may be related to the cause of the distinct presentations.
Masato Mizukoshi; Toshio Imanishi; Atsushi Tanaka; Takashi Kubo; Yong Liu; Shigeho Takarada; Hironori Kitabata; Takashi Tanimoto; Kenichi Komukai; Kohei Ishibashi; Takashi Akasaka
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  106     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-20     Completed Date:  2010-08-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  323-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright (c) 2010 Elsevier Inc. All rights reserved.
Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
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MeSH Terms
Angina, Unstable / classification*,  radiography
Coronary Angiography
Coronary Artery Disease / classification*,  radiography
Middle Aged
Prospective Studies
Statistics, Nonparametric
Tomography, Optical Coherence*

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