title: Virtual histology study of atherosclerotic plaque composition in patients with stable angina and acute phase of acute coronary syndromes without ST segment elevation.
abstract: BACKGROUND
  Rupture of vulnerable atherosclerotic plaques is the cause of most acute coronary syndromes (ACS). Postmortem studies which compared stable coronary lesions and atherosclerotic plaques in patients who have died because of ACS indicated high lipid-core content as one of the major determinants of plaque vulnerability.
  
  
  OBJECTIVE
  Our primary goal was to assess the potential relations of plaque composition determined by IVUS-VH (Intravascular Ultrasound -Virtual Histology) in patients with stable angina and subjects in acute phase of ACS without ST segment elevation.
  
  
  METHODS
  The study comprised of 40 patients who underwent preintervention IVUS examination.Tissue maps were reconstructed from radio frequency data using IVUS-VH software.
  
  
  RESULTS
  We analyzed 53 lesions in 40 patients. Stable angina was diagnosed in 24 patients (29 lesions), while acute phase of ACS without ST elevation was diagnosed in 16 patients (24 lesions). In the patients in acute phase of ACS without ST segment elevation IVUS-VH examination showed a significantly larger area of the necrotic core at the site of minimal lumen area and a larger mean of the necrotic core volume in the entire lesion comparing to stable angina subjects (1.84+/-0.90 mm2 vs. 0.96+/-0.69 mm2; p<0.001 and 20.94+/-15.79 mm3 vs. 11.54+/-14.15 mm3; p<0.05 respectively).
  
  
  CONCLUSIONS
  IVUS-VH detected that the necrotic core was significantly larger in atherosclerotic lesions in patients in acute phase of ACS without ST elevation comparing to the stable angina subjects and that it could be considered as a marker of plaque vulnerability.
authors.affiliation: Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia. milosivanovicmd@gmail.com
authors.forename: Milos
authors.initials: M
authors.lastname: Ivanovíc
authors.forename: Milan
authors.initials: M
authors.lastname: Rancić
authors.forename: Adam
authors.initials: A
authors.lastname: Rdzanek
authors.forename: Krzysztof J
authors.initials: KJ
authors.lastname: Filipjak
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Opolski
authors.forename: Jelena
authors.initials: J
authors.lastname: Cvetanović
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000503:physiopathology; D000368:Aged; D060050:Angina, Stable / Q000175:diagnosis*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D062072:Patient Acuity; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000473:pathology; D011237:Predictive Value of Tests; D011379:Prognosis; D018084:Ultrasonography, Interventional / Q000379:methods*