Feng Tian, Yundai Chen, Ying Zhou, Jing Wang, Tao Zhang
Department of Cardiology, Chinese PLA General Hospital, Beijing, China.
Cardiology. 2014;129(4):207-12. doi: 10.1159/000365185. Epub 2014 Oct 18.
This study aimed to evaluate the relationship between plaque morphology and the plaque progression (PP) that occurs despite routine medical therapy and better risk-factor control.
A total of 183 patients who received baseline and follow-up coronary angiography were divided into 2 groups, the PP group (n = 78) and the non-PP group (n = 105). Optical coherence tomography (OCT) was performed after baseline coronary angiography. The plaque characteristics were noted and the fibrous cap thickness was measured at the thinnest point of each plaque. Macrophages in the fibrous cap were detected, and the macrophage content was measured based on the signal attenuation.
The level of high-sensitivity C-reactive protein was higher in the PP group (p = 0.001). The OCT examination showed that the proportion of lipid-rich plaques in the PP group was higher than that in the non-PP group (p < 0.001). Calcified plaques were detected frequently in the non-PP group (p < 0.001). Macrophages in the fibrous cap were detected frequently in the PP group (p < 0.001), and the macrophage content was significantly greater than that in the non-PP group (p < 0.001).
Lipid-rich plaques with large numbers of macrophages were prone to PP, whereas the progression of calcified plaques was rare.
本研究旨在评估斑块形态与尽管接受常规药物治疗且危险因素控制较好但仍发生的斑块进展（PP）之间的关系。
共有183例接受了基线和随访冠状动脉造影的患者被分为两组，即PP组（n = 78）和非PP组（n = 105）。在基线冠状动脉造影后进行光学相干断层扫描（OCT）。记录斑块特征，并在每个斑块的最薄点测量纤维帽厚度。检测纤维帽中的巨噬细胞，并基于信号衰减测量巨噬细胞含量。
PP组的高敏C反应蛋白水平较高（p = 0.001）。OCT检查显示，PP组中富含脂质斑块的比例高于非PP组（p < 0.001）。在非PP组中经常检测到钙化斑块（p < 0.001）。在PP组中经常检测到纤维帽中的巨噬细胞（p < 0.001），且巨噬细胞含量显著高于非PP组（p < 0.001）。
富含脂质且有大量巨噬细胞的斑块易于发生PP，而钙化斑块进展罕见。
