Angioscopic follow-up study of coronary ruptured plaques in nonculprit lesions.
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.
Takano
Masamichi
M
Department of Internal Medicine, Chiba-Hokusoh Hospital, Nippon Medical School, Chiba, Japan.
Inami
Shigenobu
S
Ishibashi
Fumiyuki
F
Okamatsu
Kentaro
K
Seimiya
Koji
K
Ohba
Takayoshi
T
Sakai
Shunta
S
Mizuno
Kyoichi
K
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
D002097:C-Reactive Protein