title: Optical coherence tomography analysis of attenuated plaques detected by intravascular ultrasound in patients with acute coronary syndromes.
abstract: Background. Recent intravascular ultrasound (IVUS) studies have demonstrated that hypoechoic plaque with deep ultrasound attenuation despite absence of bright calcium is common in acute coronary syndrome. Such "attenuated plaque" may be an IVUS characteristic of unstable lesion. Methods. We used optical coherence tomography (OCT) in 104 patients with unstable angina to compare lesion characteristics between IVUS-detected attenuated plaque and nonattenuated plaque. Results. IVUS-detected attenuated plaque was observed in 41 (39%) patients. OCT-detected lipidic plaque (88% versus 49%, P < 0.001), thin-cap fibroatheroma (48% versus 16%, P < 0.001), plaque rupture (44% versus 11%, P < 0.001), and intracoronary thrombus (54% versus 17%, P < 0.001) were more often seen in IVUS-detected attenuated plaques compared with nonattenuated plaques. Conclusions. IVUS-detected attenuated plaque has many characteristics of unstable coronary lesion. The presence of attended plaque might be an important marker of lesion instability.
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8510, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kubo
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Matsuo
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ino
authors.forename: Takashi
authors.initials: T
authors.lastname: Tanimoto
authors.forename: Kohei
authors.initials: K
authors.lastname: Ishibashi
authors.forename: Kenichi
authors.initials: K
authors.lastname: Komukai
authors.forename: Hironori
authors.initials: H
authors.lastname: Kitabata
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tanaka
authors.forename: Keizo
authors.initials: K
authors.lastname: Kimura
authors.forename: Toshio
authors.initials: T
authors.lastname: Imanishi
authors.forename: Takashi
authors.initials: T
authors.lastname: Akasaka