Lesion characteristics of acute myocardial infarction: an investigation with intravascular ultrasound.
OBJECTIVE
To use intravascular ultrasound (IVUS) to compare plaque morphology in acute myocardial infarction and stable angina pectoris.


METHODS
Retrospective study.


METHODS
Primary care hospital.


METHODS
59 consecutive cases of acute myocardial infarction and 50 consecutive cases of stable angina pectoris.


METHODS
IVUS was used before coronary intervention.


METHODS
Plaque morphology (incidence of eccentric plaque, subtle dissections, low echoic thrombus, calcification, echolucent areas, and bright speckled echo material), assessed visually using IVUS.


RESULTS
There were no significant differences in plaque eccentricity or calcification between the two groups, but low echoic thrombus (acute myocardial infarction 15% v stable angina pectoris 0%), subtle dissections (37% v 4%), echolucent areas (31% v 0%), and bright speckled echo material (90% v 0%) were more common in the infarction group than in the stable angina group (p < 0.001 for all). There was a longer time between the onset of symptoms and the IVUS examination in patients with low echoic thrombus than in those without (p < 0.03).


CONCLUSIONS
Low echoic thrombus, subtle dissections, echolucent areas, and bright speckled echo material are morphological characteristics associated with plaque at the time of acute myocardial infarction. These findings correspond pathologically to ruptured plaque.
First Department of Internal Medicine, Osaka City University Medical School, Osaka, Japan.
D
D
Fukuda
T
T
Kawarabayashi
A
A
Tanaka
Y
Y
Nishibori
H
H
Taguchi
Y
Y
Nishida
K
K
Shimada
J
J
Yoshikawa
D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000473:pathology; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000473:pathology; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional