| Incidence and clinical correlates of ruptured plaques in saphenous vein grafts: an intravascular ultrasound study. | |
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MedLine Citation:
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PMID: 15963395 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The goal of this study was to assess the incidence, clinical correlates, and angiographic appearance of ruptured atherosclerotic plaques detected in saphenous vein grafts (SVGs). BACKGROUND: Ruptured atherosclerotic plaques in native coronary arteries but not in SVGs have been well described with intravascular ultrasound (IVUS). METHODS: We reviewed 791 pre-intervention IVUS SVG studies and identified 95 ruptured plaques in 76 SVGs in 73 patients. Standard clinical, angiographic, and IVUS measurements were collected and/or measured. Ruptured plaques were compared with nonruptured plaques in 276 randomly selected patients. RESULTS: The IVUS-detected ruptured plaques had angiographically complex morphology (95%) with ulceration (79%), intimal flap (71%), and sometimes aneurysm formation (14%). Compared with control SVG lesions, ruptured plaques occurred more often in patients with acute coronary syndromes, in older SVGs (12.3 +/- 5.0 years vs. 8.6 +/- 5.2 years, p < 0.001), and in patients with hypercholesterolemia (92% vs. 81%, p = 0.021) and hypertension (78% vs. 63%, p = 0.015). Multiple ruptured plaques were identified in 22 patients in 19 grafts, more often in diabetic patients (55% vs. 29%, p = 0.054). A tear in the fibrous cap could be identified in 59% of plaques; in 70% it occurred at the shoulder of the plaque and in 30% at the center of the plaque. The IVUS features of ruptured plaques included positive remodeling in 71%, which was more common than in control plaques (40%, p < 0.001). CONCLUSIONS: Ruptured atherosclerotic plaques occur in old SVGs with an incidence of 9.7%. These lesions have a complex angiographic appearance and positive remodeling characteristics. This is similar to ruptured plaques in native arteries. |
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Authors:
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Jerzy Pregowski; Pawel Tyczynski; Gary S Mintz; Sang-Wook Kim; Adam Witkowski; Ron Waksman; Augusto Pichard; Lowell Satler; Kenneth Kent; Mariusz Kruk; Szymon Bieganski; Patrick Ohlmann; Neil J Weissman |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 45 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2005 Jun |
Date Detail:
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Created Date: 2005-06-20 Completed Date: 2005-07-14 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1974-9 Citation Subset: AIM; IM |
Affiliation:
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Cardiovascular Research Institute/Medstar Research Institute, Washington Hospital Center, 100 Irving Street NW, Washington, DC 20020, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Coronary Artery Bypass* Coronary Artery Disease / diagnosis*, epidemiology*, surgery Female Graft Occlusion, Vascular / diagnosis*, epidemiology*, surgery Humans Incidence Male Middle Aged Risk Factors Rupture, Spontaneous / diagnosis, epidemiology, surgery Saphenous Vein / radiography, transplantation, ultrasonography* Ultrasonography, Interventional |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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