title: Correlation between plaque composition as assessed by virtual histology and C-reactive protein.
abstract: BACKGROUND
  Previous studies have shown that coronary plaque composition plays a pivotal role in plaque instability, and imaging modalities and serum biomarkers have been investigated to identify vulnerable plaque. Virtual histology IVUS (VH-IVUS) characterizes plaque components as calcified, fibrotic, fibrofatty, or necrotic core. C-reactive protein (hsCRP) is an independent risk factor and a powerful predictor of future coronary events. However, a relationship between inflammatory response indicated by CRP and plaque characteristics in ACS patients remains not well established.
  
  
  OBJECTIVE
  To determine, by using VH-IVUS, the relation between coronary plaque components and plasma high-sensitivity CRP levels in patients with acute coronary syndromes (ACS).
  
  
  METHODS
  52 patients with ACS were enrolled in this prospective study. Electrocardiographically-gated VH-IVUS were performed in the culprit lesion before PCI. Blood sample was drawn from all patients before the procedure and after 24 hours, and hs-CRP levels were determined.
  
  
  RESULTS
  Mean age was 55.3±4.9 years, 76.9% were men and 30.9% had diabetes. Mean MLA was 3.9±1.3 mm², and plaque burden was 69±11.3%, as assessed by IVUS. VH-IVUS analysis at the minimum luminal site identified plaque components: fibrotic (59.6±15.8%), fibrofatty (7.6±8.2%), dense calcium (12.1±9.2%) and necrotic core (20.7±12.7%). Plasma hs-CRP (mean 16.02±18.07 mg/L) did not correlate with necrotic core (r=-0.089, p = 0.53) and other plaque components.
  
  
  CONCLUSIONS
  In this prospective study with patients with ACS, the predominant components of the culprit plaque were fibrotic and necrotic core. Serum hs C-reactive protein levels did not correlate with plaque composition.
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, SP – Brazil. dimytri@cardiol.br
authors.forename: Dimytri Alexandre de Alvim
authors.initials: DA
authors.lastname: Siqueira
authors.forename: Amanda Guerra Moraes R
authors.initials: AG
authors.lastname: Sousa
authors.forename: José de Ribamar
authors.initials: Jde R
authors.lastname: Costa Junior
authors.forename: Ricardo Alves da
authors.initials: RA
authors.lastname: Costa
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Staico
authors.forename: Luis Fernando Leite
authors.initials: LF
authors.lastname: Tanajura
authors.forename: Marinella Patrizia
authors.initials: MP
authors.lastname: Centemero
authors.forename: Fausto
authors.initials: F
authors.lastname: Feres
authors.forename: Alexandre Antonio Cunha
authors.initials: AA
authors.lastname: Abizaid
authors.forename: J Eduardo Moraes R
authors.initials: JE
authors.lastname: Sousa
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000000981:diagnostic imaging* / Q000473:pathology*; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002118:Calcium / Q000032:analysis; D017023:Coronary Angiography; D005260:Female; D005355:Fibrosis / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000473:pathology; D058226:Plaque, Atherosclerotic / Q000097:blood / Q000737:chemistry* / Q000000981:diagnostic imaging*; D012016:Reference Values; D015203:Reproducibility of Results; D014463:Ultrasonography / Q000379:methods
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D002118:Calcium