Cardiovascular Division, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoji-ku, Osaka 543-0035, Japan.
Circ J. 2011;75(3):603-12. doi: 10.1253/circj.cj-10-0724. Epub 2010 Dec 24.
Clarification of frequency and distribution of yellow plaques and disrupted plaques will increase understanding of acute coronary syndrome (ACS) onset.
Consecutive patients with ACS (n=75) or without ACS (n=90) who received coronary angioscopic examination were studied. Distance from ostium to yellow plaques, diameter stenosis and vessel wall irregularity at the site of yellow plaques, their yellow color grade (grade 13) and if they had thrombus were analyzed. Yellow plaques with thrombus were regarded as disrupted. Average number of yellow plaques, grade-3 yellow plaques and disrupted yellow plaques per vessel was 4.0, 0.87 and 1.0, respectively. The number of grade-3 yellow plaques and disrupted yellow plaques per vessel were larger in ACS than in non-ACS patients. Yellow plaques were distributed diffusely in the right coronary artery but more in mid-segments in the left anterior descending coronary artery and left circumflex coronary artery. Diameter stenosis in the non-culprit segments was severer at disrupted than at non-disrupted yellow plaques. Vessel wall irregularity was detected more frequently at disrupted than at non-disrupted yellow plaques.
Approximately 4 yellow plaques, 1 grade-3 yellow plaque and 1 disrupted yellow plaque were detected per vessel. About 25% of detected yellow plaques were disrupted. More grade-3 yellow plaques and disrupted yellow plaques were detected in ACS than in non-ACS patients. These findings strengthen the association between yellow plaques detected by angioscopy and ACS events.
明确黄色斑块和破裂斑块的频率和分布将增加对急性冠状动脉综合征（ACS）发病机制的理解。
对接受冠状动脉血管内超声检查的连续 ACS 患者（n=75）和非 ACS 患者（n=90）进行了研究。分析了黄色斑块处距开口的距离、斑块的直径狭窄程度和血管壁不规则性、黄色斑块的黄色等级（3 级）以及是否有血栓。有血栓的黄色斑块被视为破裂斑块。每根血管的平均黄色斑块数量、3 级黄色斑块数量和破裂黄色斑块数量分别为 4.0、0.87 和 1.0。ACS 患者的 3 级黄色斑块和破裂黄色斑块数量多于非 ACS 患者。右冠状动脉的黄色斑块分布广泛，但左前降支和左旋支的中段更多。破裂黄色斑块处的非罪犯病变节段的直径狭窄更严重。破裂斑块处检测到的血管壁不规则性更频繁。
每根血管检测到约 4 个黄色斑块、1 个 3 级黄色斑块和 1 个破裂黄色斑块。约 25%的黄色斑块破裂。ACS 患者检测到的 3 级黄色斑块和破裂黄色斑块多于非 ACS 患者。这些发现加强了血管内超声检查中发现的黄色斑块与 ACS 事件之间的关联。
