Hypercholesterolemia and hypoadiponectinemia are associated with necrotic core-rich coronary plaque.
BACKGROUND
Hypercholesterolemia is a risk factor for coronary artery disease and closely linked to unstable plaque. Hypoadiponectinemia is frequently observed in patients with metabolic syndrome complicated with macroangiopathy and predicts poor clinical outcome. Spectral analysis of intravascular ultrasonography radiofrequency (IVUS-Virtual Histology [VH]) allows quantitative analysis of plaque composition. The purpose of this study was to verify the effects of low-density lipoprotein (LDL) cholesterol level on plaque morphology, and test the hypothesis that adiponectin influences coronary plaque volume and composition.


METHODS
Preintervention IVUS-VH using a continuous pullback was performed in 92 coronary vessels in 92 patients with coronary artery disease. The morphological distribution of plaque was evaluated prospectively in a 60-mm segment of coronary vessels containing the culprit lesion.


RESULTS
Serum LDL cholesterol levels correlated positively with necrotic core volume (r = 0.217, P = 0.037) and percent necrotic core tissue (r = 0.308, P = 0.003), while plasma adiponectin levels correlated negatively with plaque volume (r = -0.297, P = 0.004) and necrotic core volume (r = -0.306, P = 0.003). Multiple regression analyses showed close association between necrotic core volume and statin-use (β = -21.68, P = 0.004) and adiponectin levels (β = -31.25, P = 0.038), and that percent necrotic core tissue was influenced by statin-use (β = -4.595, P = 0.026) and LDL cholesterol levels (β = 0.092, P = 0.031).


CONCLUSIONS
Adiponectin is closely linked to coronary plaque volume. Hypercholesterolemia and hypoadiponectinemia correlate with necrotic core lesions and may contribute to increased risk of coronary plaque vulnerability. Statins can affectively prevent necrotic core plaque formation associated with hypercholesterolemia and hypoadiponectinemia.
Kojima
Shinobu
S
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. kojimas@kumamoto-u.ac.jp
Kojima
Sunao
S
Maruyoshi
Hidetomo
H
Nagayoshi
Yasuhiro
Y
Kaikita
Koichi
K
Sumida
Hitoshi
H
Sugiyama
Seigo
S
Funahashi
Tohru
T
Ogawa
Hisao
H
D052242:Adiponectin / Q000097:blood* / Q000172:deficiency*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood* / Q000473:pathology*; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D058226:Plaque, Atherosclerotic / Q000097:blood* / Q000473:pathology*; D011446:Prospective Studies
D052242:Adiponectin; D015415:Biomarkers