Relation between plaque components and plaque prolapse after drug-eluting stent implantation--virtual histology-intravascular ultrasound.
BACKGROUND
It is not well known which plaque components are associated with the development of plaque prolapse (PP) and what are the major components in prolapsed plaque. The relationship between pre-stenting plaque components and post-stenting PP was assessed and the plaque components of prolapsed plaque were evaluated in patients who underwent drug-eluting stent (DES) implantation using virtual histology-intravascular ultrasound (VH-IVUS).


RESULTS
The study group consisted of 132 patients who underwent DES implantation and pre- and post-stenting VH-IVUS. Of these patients, 68 patients had 76 PP lesions and 64 patients had 76 non-PP lesions. Intra-stent PP volume was 3.6+/-1.5 mm(3). Plaque volume was significantly greater and absolute fibrotic (FT) and necrotic core (NC) volumes were significantly greater in PP lesions compared with non-PP lesions. On multivariate analysis, absolute NC (odds ratios [OR]=1.14, P<0.001) and FT volume (OR =1.09, P<0.001) were independently associated with the development of PP. In intra-stent prolapsed plaque the FT component was greatest, but the NC component was also large, and %NC volume correlated positively with Deltacreatine kinase-MB (r=0.489, P<0.001) and Deltatroponin-I (r=0.679, P<0.001), and %FT volume correlated negatively with DeltaCK-MB (r=-0.539, P<0.001) and Deltatroponin-I.


CONCLUSIONS
NC and FT components were associated with development of PP; and NC and FT components in prolapsed plaque were associated with cardiac enzyme elevation after DES implantation.
Hong
Young Joon
YJ
Heart Research Center of Chonnam National University Hospital, Gwangju, Korea.
Jeong
Myung Ho
MH
Kim
Sang Wook
SW
Choi
Yun Ha
YH
Ma
Eun Hae
EH
Ko
Jum Suk
JS
Lee
Min Goo
MG
Park
Keun Ho
KH
Sim
Doo Sun
DS
Yoon
Nam Sik
NS
Yoon
Hyun Ju
HJ
Kim
Kye Hun
KH
Park
Hyung Wook
HW
Kim
Ju Han
JH
Ahn
Youngkeun
Y
Cho
Jeong Gwan
JG
Park
Jong Chun
JC
Kang
Jung Chaee
JC
D000368:Aged; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000473:pathology; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D005355:Fibrosis; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011391:Prolapse; D012189:Retrospective Studies; D013927:Thrombosis / Q000473:pathology* / Q000628:therapy; D018084:Ultrasonography, Interventional