Document Detail


Virtual histology intravascular ultrasound analysis of non-culprit attenuated plaques detected by grayscale intravascular ultrasound in patients with acute coronary syndromes.
MedLine Citation:
PMID:  20102889     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Noncalcific attenuated plaques identified by grayscale intravascular ultrasound (IVUS) are often seen in patients with acute coronary syndromes and have been associated with no reflow and creatine kinase-MB elevation after percutaneous coronary intervention. Histopathology has shown cholesterol clefts, microcalcification, or organized thrombus. One hundred twenty-four vessels in 64 patients with acute coronary syndromes from the PROSPECT trial were identified for inclusion in the present analysis. After excluding 4 vessels with severe calcification, 9 vessels with <40% plaque burden, and 3 vessels with too few (<3) virtual histology (VH)-IVUS frames for analysis, complete grayscale IVUS and VH-IVUS was available for 108 vessels in 64 patients that contained 39 VH-IVUS thin-capped fibroatheromas (VH-TCFA), 40 thick-capped fibroatheromas (VH-ThFA), and 33 pathologic intimal thickening but no fibrotic or fibrocalcific plaques. Overall, there were 47 grayscale IVUS attenuated plaques in 43 vessels. Compared to the minimum luminal sites of the remaining 65 vessels (controls), attenuated plaques contained larger necrotic core areas (1.5 +/- 0.9 vs 0.9 +/- 0.8 mm(2) in controls, p = 0.001). Fibroatheromas (VH-TCFA or VH-ThFA) were more common at the sites of attenuated plaques than at control sites (VH-TCFA 42.5% vs 29.2%, VH-ThFA 53.2% vs 23.1%, pathologic intimal thickening 4.3% vs 47.7%, p <0.0001). In conclusion, grayscale IVUS attenuated plaques are associated with a large amount of VH-IVUS necrotic core and are markers of the presence of fibroatheromas (VH-TCFA or VH-ThFA). This may explain the biologic instability of these lesions.
Authors:
Xiaofan Wu; Akiko Maehara; Gary S Mintz; Takashi Kubo; Kai Xu; So-Yeon Choi; Yong He; Ning Guo; Jeffrey W Moses; Martin B Leon; Bernard De Bruyne; Patrick W Serruys; Gregg W Stone
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial     Date:  2009-11-18
Journal Detail:
Title:  The American journal of cardiology     Volume:  105     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-27     Completed Date:  2010-03-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  48-53     Citation Subset:  AIM; IM    
Affiliation:
Columbia University Medical Center and Cardiovascular Research Foundation, New York, NY, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / pathology,  physiopathology,  ultrasonography*
Computer Simulation*
Coronary Vessels / pathology*,  ultrasonography
Diagnosis, Differential
Disease Progression
Electrocardiography
Female
Follow-Up Studies
Humans
Male
Middle Aged
Prognosis
Prospective Studies
Reproducibility of Results
Ultrasonography, Interventional / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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