Li Xin-ming, Huang Cong-xin, Wang Tian-song, Zhuang Shao-wei, Zhou Hua, Tian Bei
Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 320089, China.
Chin Med J (Engl). 2008 Mar 20;121(6):534-9.
The identification of vulnerable plaques before rupture is an important clinical goal. The purpose of the present study was to assess the difference in plaque composition among patients with acute coronary syndrome (ACS) and stable coronary artery disease (SCAD) by intravascular ultrasound virtual histologic analysis.
One hundred and thirty-nine patients were divided into ACS group and SCAD group according to clinical presentation. A total of 229 de novo lesions with >50% stenosis in native coronary arteries with diameters >2.5 mm were studied with intravascular ultrasonography. Geometric and compositional data were obtained using intravascular ultrasound virtual histology software.
There were no significant differences in overall lesions for fibrous ((52.0+/-11.9)% vs (54.3+/-8.5)%, P>0.05), fibrolipidic ((12.3+/-10.1)% vs (13.8+/-9.5)%, P > 0.05), calcium ((14.0+/-9.1)% vs (19.3+/-13.1)%, P>0.05), or necrotic core ((22.0+/-11.1)% vs (19.7 +/- 5.4)%, P > 0.05) percentages in ACS and SCAD patients, respectively. There were also no significant differences in culprit lesions for fibrous ((46.4+/-12.0)% vs (53.6+/-8.8)%, P>0.05), fibrolipidic ((9.1+/-9.0)% vs (12.9+/-9.7)%, P>0.05), calcium ((16.6+/-9.7)% vs (21.8+/-26.3)%, P>0.05), or necrotic core ((28.0+/-12.6)% vs (20.6+/-5.2)%, P>0.05) percentages in ACS and SCAD patients, respectively. High density lipoprotein-cholesterol levels >1.04 mmol/L were associated with more fibrolipidic ((14.5+/-10.4)% vs (7.1+/-6.5)%, P<0.05) and less necrotic core ((20.6+/-9.7)% vs (27.9+/-12.6)%, P<0.05) percentages in the cohort with ACS.
In this study, coronary plaque composition assessed by intravascular ultrasound virtual histologic analysis was not significantly different between ACS and SCAD patients. The anatomic relationship of the specific plaque components to the lumen of the vessel was more important than the quantitative information of plaque composition for plaque stability.
在斑块破裂前识别易损斑块是一项重要的临床目标。本研究的目的是通过血管内超声虚拟组织学分析评估急性冠状动脉综合征（ACS）患者和稳定型冠状动脉疾病（SCAD）患者之间斑块成分的差异。
根据临床表现将139例患者分为ACS组和SCAD组。对总共229个直径>2.5 mm的天然冠状动脉中狭窄>50%的新发病变进行血管内超声检查。使用血管内超声虚拟组织学软件获取几何和成分数据。
ACS患者和SCAD患者在纤维斑块（分别为(52.0±11.9)% 对 (54.3±8.5)%, P>0.05）、纤维脂质斑块（分别为(12.3±10.1)% 对 (13.8±9.5)%, P>0.05）、钙化斑块（分别为(14.0±9.1)% 对 (19.3±13.1)%, P>0.05）或坏死核心（分别为(22.0±11.1)% 对 (19.7±5.4)%, P>0.05）百分比方面，总体病变无显著差异。在ACS患者和SCAD患者中，罪犯病变的纤维斑块（分别为(46.4±12.0)% 对 (53.6±8.8)%, P>0.05）、纤维脂质斑块（分别为(9.1±9.0)% 对 (12.9±9.7)%, P>0.05）、钙化斑块（分别为(16.6±9.7)% 对 (21.8±26.3)%, P>0.05）或坏死核心（分别为(28.0±12.6)% 对 (20.6±5.2)%, P>0.05）百分比也无显著差异。在ACS队列中，高密度脂蛋白胆固醇水平>1.04 mmol/L与更多的纤维脂质斑块（分别为(14.5±10.4)% 对 (7.1±6.5)%, P<0.05）和更少的坏死核心（分别为(20.6±9.7)% 对 (27.9±12.6)%, P<0.05）百分比相关。
在本研究中，通过血管内超声虚拟组织学分析评估的冠状动脉斑块成分在ACS患者和SCAD患者之间无显著差异。对于斑块稳定性而言，特定斑块成分与血管腔的解剖关系比斑块成分的定量信息更重要。
