Surmely Jean-François, Nasu Kenya, Fujita Hiroshi, Terashima Mitsuyasu, Matsubara Tetsuo, Tsuchikane Etsuo, Ehara Mariko, Kinoshita Yoshihisa, Zheng Quan Xiu, Tanaka Nobuyoshi, Katoh Osamu, Suzuki Takahiko
Department of Cardiology, Toyohashi Heart Center, 21-1, Gobudori, Oyama,Toyohashi, Aichi 441-8530, Japan.
Eur Heart J. 2006 Dec;27(24):2939-44. doi: 10.1093/eurheartj/ehl285. Epub 2006 Oct 13.
To evaluate the plaque composition obtained by virtual histology (VH) IVUS according to the clinical presentation and to compare those data to previously published histopathology data.
VH was performed on 95 de novo significant lesions (>75% stenosis) in 85 patients [28 acute coronary syndrome (ACS) patients, 30 lesions; 57 stable angina pectoris (SAP) patients, 65 lesions]. There were a higher prevalence of positive remodelling (47 vs. 22%, P=0.013), thrombus (20 vs. 1.5%, P=0.0037), and echo-lucent area (23.3 vs. 7.7%, P=0.047) in ACS patients. At the minimal lumen site, fibrous plaque area was significantly larger in ACS lesions than in SAP lesions (66.0+/-10.7 vs. 61.4+/-8.9%, P=0.034), whereas necrotic core and dense calcium plaque area were smaller in ACS lesions (Necrotic core: 6.8+/-6.0 vs. 11.0+/-8.3%, P=0.02; Dense calcium: 2.6+/-3.0 vs. 4.9+/-5.8%, P=0.03). No differences in rate of thin cap fibroatheroma, thick fibrotheroma, or for the presence of multiple necrotic core layers were observed between both groups.
Plaque composition obtained by VH-IVUS shows less necrotic core and more fibrous tissue in ACS compared to SAP lesions, which is in contradiction with previously published histopathologic data.
