Coronary plaque composition of culprit/target lesions according to the clinical presentation: a virtual histology intravascular ultrasound analysis.
OBJECTIVE
To evaluate the plaque composition obtained by virtual histology (VH) IVUS according to the clinical presentation and to compare those data to previously published histopathology data.


RESULTS
VH was performed on 95 de novo significant lesions (>75% stenosis) in 85 patients [28 acute coronary syndrome (ACS) patients, 30 lesions; 57 stable angina pectoris (SAP) patients, 65 lesions]. There were a higher prevalence of positive remodelling (47 vs. 22%, P=0.013), thrombus (20 vs. 1.5%, P=0.0037), and echo-lucent area (23.3 vs. 7.7%, P=0.047) in ACS patients. At the minimal lumen site, fibrous plaque area was significantly larger in ACS lesions than in SAP lesions (66.0+/-10.7 vs. 61.4+/-8.9%, P=0.034), whereas necrotic core and dense calcium plaque area were smaller in ACS lesions (Necrotic core: 6.8+/-6.0 vs. 11.0+/-8.3%, P=0.02; Dense calcium: 2.6+/-3.0 vs. 4.9+/-5.8%, P=0.03). No differences in rate of thin cap fibroatheroma, thick fibrotheroma, or for the presence of multiple necrotic core layers were observed between both groups.


CONCLUSIONS
Plaque composition obtained by VH-IVUS shows less necrotic core and more fibrous tissue in ACS compared to SAP lesions, which is in contradiction with previously published histopathologic data.
Surmely
Jean-François
JF
Department of Cardiology, Toyohashi Heart Center, 21-1, Gobudori, Oyama,Toyohashi, Aichi 441-8530, Japan. j-f.surmely@heart-center.or.jp
Nasu
Kenya
K
Fujita
Hiroshi
H
Terashima
Mitsuyasu
M
Matsubara
Tetsuo
T
Tsuchikane
Etsuo
E
Ehara
Mariko
M
Kinoshita
Yoshihisa
Y
Zheng
Quan Xiu
QX
Tanaka
Nobuyoshi
N
Katoh
Osamu
O
Suzuki
Takahiko
T
D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000473:pathology; D003198:Computer Simulation / Q000592:standards*; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000473:pathology; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D020257:Ventricular Remodeling