Difference of dilation resistance to coronary stenting between fibrous plaques and lipid-rich plaques.
BACKGROUND
Dilation resistance to stenting in non-calcified coronary plaques was compared in patients with percutaneous coronary intervention (PCI) in order to confirm the clinical usefulness of multislice computed tomography in examining coronary plaque type and to provide information pertaining to the effects of plaque type on dilatation resistance.


METHODS
A retrospective analysis of 64-slice computed tomography coronary imaging data collected in the month prior to coronary stenting in 93 patients (65 male and 28 female, mean age of (57.22±7.22) years) was conducted. Non-calcified coronary plaques were divided into lipid-rich (lipid content >25% of plaque volume) and fibrous plaques according to the Hammer-Hansen S method: where lipids, fiber, and intraluminal components were indicated by contrast using Hu values of -100-49, 50-129, and >130, respectively. Clinical features, pre-dilatation balloon specifications and filling pressure, and stent size and release pressure were compared.


RESULTS
High-sensitivity C-reactive protein levels were higher in the lipid-rich plaque group. In patients with typical symptoms, unstable angina was more commonly observed in the lipid-rich plaque group. No significant differences in low density lipoprotein, pre-dilatation balloon specifications, pre-dilatation pressure, or stent specifications were observed. Stent release pressure in the lipid-rich plaque group ((1130.16±202.04) kPa), was significantly lower than that observed in the fibrous plaque group ((1240.61±193.29) kPa, P = 0.009).


CONCLUSIONS
Softer, lipid-rich plaques exhibit lower dilation resistance during stenting in PCI patients.
Department of Cardiology, Wuhan Central Hospital, Wuhan, Hubei 430014, China.
Yi
Y
Zhou
Man-Hua
MH
Chen
Kai
K
Yang
Cai-Jin
CJ
Xiong
Gang
G
Chen
Fei-Yan
FY
Yang
Gang
G
Tan
D002097:C-Reactive Protein / Q000378:metabolism; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008055:Lipids / Q000502:physiology; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D062645:Percutaneous Coronary Intervention; D058226:Plaque, Atherosclerotic / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies
D008055:Lipids; D002097:C-Reactive Protein