Open AccessPlaque Characteristics of the Coronary Segment Proximal to the Culprit Lesion in Stable and Unstable Patients
Author(s) -
Nakamura Tomohiro,
Kubo Norifumi,
Funayama Hiroshi,
Sugawara Yoshitaka,
Ako Junya,
Momomura Shinichi
Publication year - 2009
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.20471
Subject(s) - medicine , culprit , unstable angina , acute coronary syndrome , cardiology , intravascular ultrasound , vulnerable plaque , coronary artery disease , percutaneous coronary intervention , stenosis , lesion , radiology , myocardial infarction , surgery
Background Identifying vulnerable plaque is important for preventing an acute coronary event. The present study examined the relationship between the clinical presentation of coronary artery disease and the plaque characteristics of nonculprit segment assessed by virtual histology intravascular ultrasound (VH‐IVUS). Method We performed VH‐IVUS analysis on nonculprit segments with < 50% diameter stenosis in 91 patients (48 acute coronary syndrome [ACS] patients, 43 stable angina [SA] patients). Results ACS patients showed significantly higher ratio of dense calcium (7.9% ± 1.0% versus 5.0% ± 0.9%, p = 0.03) and necrotic core plaque (13.7% ± 1.1% versus 8.6% ± 1.1%, p = 0.001) compared with SA patients. VH‐IVUS‐derived thin‐cap fibroatheroma (VH‐TCFA) was more frequently observed in ACS patients compared with SA patients (64.6% versus 35.7%, p = 0.006). Among ACS patients, plasma high sensitivity C‐reactive protein (hs‐CRP) levels were significantly higher in patients with VH‐TCFA than in patients without VH‐TCFA (7.9 ± 2.6 mg/l versus 1.6 ± 0.3 mg/l, p = 0.004). Conclusion ACS patients presented higher prevalence of VH‐TCFA in nonculprit segment. Presence of VH‐TCFA was associated with an increased level of plasma hs‐CRP in ACS patients. Copyright © 2009 Wiley Periodicals, Inc.