|The effect of lipid and inflammatory profiles on the morphological changes of lipid-rich plaques in patients with non-ST-segment elevated acute coronary syndrome: follow-up study by optical coherence tomography and intravascular ultrasound.|
|PMID: 20650439 Owner: NLM Status: MEDLINE|
|OBJECTIVES: The aim of this study was to determine the relationship between the morphological changes of nonculprit lipid-rich plaques and several clinical profiles in patients with non-ST-segment elevated acute coronary syndrome (NSTEACS).
BACKGROUND: Identification of coronary lesion with morphological characteristics of rupture-prone plaques is still difficult.
METHODS: Eighty-two consecutive patients with NSTEACS who underwent percutaneous coronary intervention were enrolled. The changes in total atheroma volume (TAV) of residual nonculprit lipid-rich plaques and the changes in the corresponding fibrous cap thickness (FCT) were assessed by intravascular ultrasound and optical coherence tomography, respectively, at baseline and after 9 months.
RESULTS: The percentage changes in TAV (mm(3)) of lipid-rich plaques and in the corresponding FCT (microm) over the 9-month follow-up period were 3.1 +/- 11% and 15 +/- 17%, respectively. There was no significant correlation between the changes in TAV and those in FCT. The change in TAV showed a significant correlation with reduction of the low-density lipoprotein/high-density lipoprotein (LDL/HDL) ratio (r = 0.42, p < 0.01). In contrast, the change in FCT showed no correlation with LDL/HDL ratio but had a significant positive correlation with changes in high-sensitivity C-reactive protein (r = 0.44, p < 0.01). Furthermore, in multivariate logistic analysis, statin use was an independent predictor of changes in well-stabilized plaques that showed both TAV reduction and FCT increase.
CONCLUSIONS: The changes in TAV and FCT of coronary plaques over a 9-month observation period were related to 2 different independent factors (i.e., reduction of LDL-cholesterol and high-sensitivity C-reactive protein, respectively). Furthermore, lipid-lowering therapy with statin has the potential to stabilize these parameters by both plaque reduction and FCT.
|Shigeho Takarada; Toshio Imanishi; Kohei Ishibashi; Takashi Tanimoto; Kenichi Komukai; Yasushi Ino; Hironori Kitabata; Takashi Kubo; Atsushi Tanaka; Keizo Kimura; Masato Mizukoshi; Takashi Akasaka|
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|Type: Comparative Study; Journal Article|
|Title: JACC. Cardiovascular interventions Volume: 3 ISSN: 1876-7605 ISO Abbreviation: JACC Cardiovasc Interv Publication Date: 2010 Jul|
|Created Date: 2010-07-23 Completed Date: 2010-11-08 Revised Date: 2012-08-29|
Medline Journal Info:
|Nlm Unique ID: 101467004 Medline TA: JACC Cardiovasc Interv Country: United States|
|Languages: eng Pagination: 766-72 Citation Subset: IM|
|Copyright 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.|
|Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.|
|APA/MLA Format Download EndNote Download BibTex|
Acute Coronary Syndrome
Aged, 80 and over
Angioplasty, Balloon, Coronary*
Biological Markers / blood
C-Reactive Protein / metabolism*
Cholesterol, HDL / blood
Cholesterol, LDL / blood*
Coronary Artery Disease / blood, complications, diagnosis, therapy*
Coronary Vessels* / pathology, ultrasonography
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Inflammation Mediators / blood*
Tomography, Optical Coherence*
|0/Biological Markers; 0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Inflammation Mediators; 9007-41-4/C-Reactive Protein|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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