title: Angioscopic follow-up study of coronary ruptured plaques in nonculprit lesions.
abstract: OBJECTIVE
  Changes of ruptured plaques in nonculprit lesions were evaluated using coronary angioscopy.
  
  
  BACKGROUND
  The concept of multiple coronary plaque ruptures has been established. However, no detailed follow-up studies of ruptured plaques in nonculprit lesions have yet been reported.
  
  
  METHODS
  Forty-eight thrombi in 50 ruptured coronary plaques in nonculprit lesions in 30 patients were identified by angioscopy. The percent diameter stenosis (%DS) at the target plaques on quantitative coronary angiographic analysis and the serum C-reactive protein (CRP) level were measured.
  
  
  RESULTS
  The mean angioscopic follow-up period was 13 +/- 9 months. Thirty-five superimposed thrombi still remained at follow-up, and the predominant thrombus color changed from red (56%) at baseline to pinkish-white (83%) at follow-up. The healing rate increased according to the angioscopic follow-up period (23% at </=12 months vs. 55% at >12 months, p = 0.044). The %DS at the healed plaque increased from baseline to follow-up (12.3 +/- 5.8% vs. 22.7 +/- 11.6%, respectively; p = 0.0004). The serum CRP level in patients with healed plaques (n = 10) was lower than that in those without healed plaques (n = 19; 0.07 +/- 0.03 mg/dl vs. 0.15 +/- 0.11 mg/dl, respectively; p = 0.007).
  
  
  CONCLUSIONS
  The present study demonstrated that: 1) ruptured plaques in nonculprit lesions tend to heal slowly with a progression of angiographic stenosis; and 2) the serum CRP level might reflect the disease activity of the plaque ruptures.
authors.affiliation: Department of Internal Medicine, Chiba-Hokusoh Hospital, Nippon Medical School, Chiba, Japan.
authors.forename: Masamichi
authors.initials: M
authors.lastname: Takano
authors.forename: Shigenobu
authors.initials: S
authors.lastname: Inami
authors.forename: Fumiyuki
authors.initials: F
authors.lastname: Ishibashi
authors.forename: Kentaro
authors.initials: K
authors.lastname: Okamatsu
authors.forename: Koji
authors.initials: K
authors.lastname: Seimiya
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohba
authors.forename: Shunta
authors.initials: S
authors.lastname: Sakai
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Mizuno
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017546:Angioscopy; D002097:C-Reactive Protein / Q000032:analysis; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis*; D023921:Coronary Stenosis / Q000175:diagnosis*; D003328:Coronary Thrombosis / Q000175:diagnosis*; D004730:Endothelium, Vascular / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy; D012422:Rupture, Spontaneous; D014945:Wound Healing / Q000502:physiology
chemical_list: D002097:C-Reactive Protein