Hong Myeong-Ki, Mintz Gary S, Lee Cheol Whan, Park Kyoung-Min, Lee Bong-Ki, Kim Young-Hak, Kang Duk-Hyun, Cheong Sang-Sig, Song Jae-Kwan, Kim Jae-Joong, Park Seong-Wook, Park Seung-Jung
Department of Medicine, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Poongnap-dong, Songpa-gu, Seoul 138-736, Republic of Korea.
Int J Cardiol. 2007 Jan 2;114(1):78-82. doi: 10.1016/j.ijcard.2006.01.008. Epub 2006 May 18.
Plaque rupture is more frequently observed in patients with acute coronary syndrome (ACS) rather than in patients with stable angina pectoris (SAP). Consequently, studies regarding plaque rupture, which occurred in SAP patients, are rare. Therefore, we evaluated the frequency and axial location of plaque ruptures in SAP patients and compared them with those in ACS patients.
Three hundred ninety-two patients (231 ACS and 161 SAP patients) who were scheduled for coronary intervention underwent three-vessel intravascular ultrasound (IVUS) study. IVUS criteria for plaque rupture were a plaque contained a cavity that communicated with the lumen with an overlying residual fibrous cap fragment. Using motorized IVUS transducer pullback in all three coronary arteries, the distance between each coronary plaque rupture segment and the respective coronary ostium was measured.
Plaque ruptures were detected in 206 of 392 patients who underwent three-vessel intravascular ultrasound examination. At least one plaque rupture in any coronary artery was noted in 48 (30%) SAP and 158 (68%) ACS patients (p<0.001). In both ACS and SAP patients, plaque ruptures were clustered mainly in the proximal segments of the left anterior descending artery and in the proximal and distal segments of the right coronary artery.
At least one plaque rupture in any coronary artery was noted in 30% of SAP patients. Like in ACS patients, plaque ruptures were clustered mainly in the proximal segments of the left anterior descending artery and in the proximal and distal segments of the right coronary artery in SAP patients.
与稳定型心绞痛（SAP）患者相比，急性冠状动脉综合征（ACS）患者更常出现斑块破裂。因此，关于SAP患者发生斑块破裂的研究很少。所以，我们评估了SAP患者斑块破裂的频率和轴向位置，并将其与ACS患者的进行比较。
392例计划进行冠状动脉介入治疗的患者（231例ACS患者和161例SAP患者）接受了三支血管的血管内超声（IVUS）检查。斑块破裂的IVUS标准是斑块内有一个与管腔相通的腔隙，其上方有残余纤维帽碎片。使用电动IVUS换能器回撤技术在所有三支冠状动脉中测量每个冠状动脉斑块破裂节段与相应冠状动脉开口之间的距离。
在接受三支血管血管内超声检查的392例患者中，检测到206例斑块破裂。48例（30%）SAP患者和158例（68%）ACS患者在任何冠状动脉中至少发现一处斑块破裂（p<0.001）。在ACS和SAP患者中，斑块破裂主要集中在左前降支近端节段以及右冠状动脉近端和远端节段。
30%的SAP患者在任何冠状动脉中至少发现一处斑块破裂。与ACS患者一样，SAP患者的斑块破裂也主要集中在左前降支近端节段以及右冠状动脉近端和远端节段。
