Coronary plaque dimensions and composition by intravascular ultrasound radio frequency lesion segment analysis in stable and unstable angina patients.
OBJECTIVE
We hypothesized that the plaque composition and plaque type classification differs between acute coronary syndrome (ACS) and stable angina (SA) patients.


RESULTS
We analyzed culprit lesion (CL) and nonculprit lesion (NCL) of ACS patients compared with target lesion (TL) and nontarget lesion (NTL) of SA patients by intravascular ultrasound radio frequency analysis in 874 lesion segments of 424 patients (ACS: 193 patients/SA: 231 patients). Comparing all lesion segments in ACS and SA patients did not show significant differences in absolute or relative plaque composition. However, necrotic core area was larger in CL versus TL (0.9+/-0.7 vs. 0.7+/-0.5 mm, P=0.005) and all plaque components were significantly higher in CL compared with NCL and TL compared with NTL, respectively. A higher amount of thin cap fibroatheroma lesions (15.2 vs. 5.1%, P<0.0001) was detected in ACS compared with SA patients. Fibrocalcific lesions were lower in ACS patients (3 vs. 10.5%, P<0.0001).


CONCLUSIONS
The differentiation in CL/NCL of ACS and TL/NTL of SA patients revealed significant differences in plaque composition and plaque types when examined by intravascular ultrasound radiofrequency analysis. However, considerable overlap between plaque characteristics exists for ACS and SA patients.
König
Andreas
A
Division of Cardiology, Department of Medicine, Medizinische Klinik und Poliklinik - Innenstadt, Ludwig-Maximilians-Universität, Munich 80336, Germany. Andreas.Koenig@med.uni-muenchen.de
Bleie
Oyvind
O
Dudek
Darius
D
Marso
Steve
S
Rogers
Jason H
JH
Dave
Rajesh
R
Tanaka
Kaoru
K
Siebert
Uwe
U
Wijns
William
W
Klauss
Volker
V
D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging* / Q000209:etiology; D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging* / Q000209:etiology; D000789:Angina, Unstable / Q000000981:diagnostic imaging* / Q000209:etiology; D002114:Calcinosis / Q000000981:diagnostic imaging; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D005355:Fibrosis; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011237:Predictive Value of Tests; D012042:Registries; D012044:Regression Analysis; D018084:Ultrasonography, Interventional; D014481:United States