Document Detail

Frequency and evolution of thin-capped fibroatheromas in left main coronary artery as assessed by serial virtual histology intravascular ultrasound analysis.
MedLine Citation:
PMID:  24717275     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: The objective of the current study was to assess thin-capped fibroatheroma (TCFA) of the left main coronary artery (LMCA) and its changes after statin therapy.
METHODS: We assessed the frequency and distribution of virtual histology intravascular ultrasound (VH-IVUS) thin-capped fibroatheroma (VH-TCFA) in the LMCA in 500 patients. Serial VH-IVUS examinations were available in 50 patients at 12-month follow-up.
RESULTS: The incidence of LM-TCFA was 8.8% (44/500). IVUS LMCA length was longer in patients with VH-TCFA vs without VH-TCFA. Reference external elastic membrane (EEM) area was similar, but reference lumen area and minimal lumen area were smaller in LMCA with VH-TCFA vs without VH-TCFA (P<.001). LMCA with VH-TCFA had a higher plaque burden (P<.001), a larger necrotic core area (P<.001), and more dense calcium (P<.001) at the maximum necrotic core (NC) site vs LMCA without VH-TCFA. In patients with an LMCA length greater than the median, 62% were located in the distal half of the LMCA. After 12 months of statin therapy, only 44.4% (4/9) of VH-TCFA had evolved to a non- VH-TCFA phenotype and 3 new VH-TCFA had appeared.
CONCLUSION: VH-TCFAs are clustered in the distal half of the LMCA with infrequent positive remodeling. It might persist despite the usual dose of statin therapy. Further study should confirm the changes in large vessels like the LMCA.
Sang-Wook Kim; Gary S Mintz; Neil J Weissman; Wang Soo Lee; Nagendra Boopathy Senguttuvan; Jee Eun Kwon; Hyangkyoung Kim; Jae Seung Seo; Ju Won Seok; Eun Young Kim; Seong Hyeop Hyeon; Joon Hwa Hong; Chee Jeong Kim; Dai Yun Cho; Tae Ho Kim
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  26     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2014 Apr 
Date Detail:
Created Date:  2014-04-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  175-9     Citation Subset:  IM    
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