| Virtual histology intravascular ultrasound analysis of non-culprit attenuated plaques detected by grayscale intravascular ultrasound in patients with acute coronary syndromes. | |
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MedLine Citation:
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PMID: 20102889 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial Date: 2009-11-18 |
Journal Detail:
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Title: The American journal of cardiology Volume: 105 ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2010-01-27 Completed Date: 2010-03-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 48-53 Citation Subset: AIM; IM |
Affiliation:
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Columbia University Medical Center and Cardiovascular Research Foundation, New York, NY, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Coronary Syndrome
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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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