title: Coronary plaque composition of culprit/target lesions according to the clinical presentation: a virtual histology intravascular ultrasound analysis.
abstract: 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.
authors.affiliation: Department of Cardiology, Toyohashi Heart Center, 21-1, Gobudori, Oyama,Toyohashi, Aichi 441-8530, Japan. j-f.surmely@heart-center.or.jp
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Surmely
authors.forename: Kenya
authors.initials: K
authors.lastname: Nasu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujita
authors.forename: Mitsuyasu
authors.initials: M
authors.lastname: Terashima
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Matsubara
authors.forename: Etsuo
authors.initials: E
authors.lastname: Tsuchikane
authors.forename: Mariko
authors.initials: M
authors.lastname: Ehara
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kinoshita
authors.forename: Quan Xiu
authors.initials: QX
authors.lastname: Zheng
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Tanaka
authors.forename: Osamu
authors.initials: O
authors.lastname: Katoh
authors.forename: Takahiko
authors.initials: T
authors.lastname: Suzuki
mesh_terms: 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