title: Systemic and local factors associated with coronary plaque disruption.
abstract: BACKGROUND
  Yellow plaques are regarded vulnerable; and disrupted yellow plaques are the major cause of acute coronary syndrome. We examined the factors associated with the disruption of yellow plaques among patients and lesion characteristics.
  
  
  METHODS
  Consecutive 161 patients with ischemic heart diseases who received coronary angioscopic examination were analyzed. Yellow plaques in the segments to which intervention had never been performed were included, and their yellow color grade and presence/ absence of disruption were examined. Associated factors for plaque disruption were examined among patients and lesion characteristics.
  
  
  RESULTS
  In 161 patients, 392 yellow plaques were included for analysis and 70 of them were disrupted. Frequency of plaque disruption (=disrupted / all yellow plaques) was significantly higher at the segments of severer stenosis (stenosis≥75% vs. 75-25% vs. <25%: 34% vs. 21% vs. 14%, p=0.006). Multivariate analysis revealed angiographic stenosis (odds ratio [OR], 1.014; 95% confidence interval [CI], 1.005-1.023; p=0.003), yellow color grade (OR, 3.297; 95% CI, 2.062-5.273, p<0.001), LDL-cholesterol (OR, 1.012; 95% CI, 1.004-1.020, p=0.003), male gender (OR, 3.608; 95% CI, 1.538-8.465; p=0.003), and hypertension (OR, 2.552; 95% CI, 1.094-5.953; p=0.030) as significant associated factors for plaque disruption.
  
  
  CONCLUSIONS
  Angiographic stenosis, yellow color grade, LDL-cholesterol, male gender, and hypertension were significantly associated with the disruption of yellow plaques.
authors.affiliation: Cardiovascular Division, Osaka Police Hospital, Osaka, Japan. ueda@oph.gr.jp
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Ueda
authors.forename: Koshi
authors.initials: K
authors.lastname: Matsuo
authors.forename: Mayu
authors.initials: M
authors.lastname: Nishio
authors.forename: Akio
authors.initials: A
authors.lastname: Hirata
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Nemoto
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Asai
authors.forename: Ayaka
authors.initials: A
authors.lastname: Murakami
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kashiwase
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Kodama
mesh_terms: D008078:Cholesterol, LDL / Q000097:blood*; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000473:pathology*; D023921:Coronary Stenosis / Q000097:blood / Q000453:epidemiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000453:epidemiology* / Q000473:pathology*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution
chemical_list: D008078:Cholesterol, LDL