Kim Hyung Oh, Kim Chong Jin, Cho Jin-Man, Soeda Tsunenari, Kurihara Osamu, Russo Michele, Araki Makoto, Lee Hang, Minami Yoshiyasu, Jang Ik-Kyung
Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Department of Medicine, Graduate School, Kyung Hee University, Seoul, South Korea.
Catheter Cardiovasc Interv. 2021 Feb 15;97(3):E298-E305. doi: 10.1002/ccd.29005. Epub 2020 May 28.
To investigate the non-culprit plaques (NCPs) characteristics in acute coronary syndrome (ACS) patients with calcified plaques (CP).
Recently, a new in vivo classification of calcified culprit plaques in patients with ACS was proposed. Characteristics of NCPs in this group of patients are unknown.
A total of 692 NCPs from 492 ACS patients were retrospectively compared based on the culprit plaque phenotype: 71 from CP patients, 383 from plaque rupture (PR) patients, 238 from plaque erosion (PE) patients.
NCPs of CP patients had greater maximal calcium thickness, wider calcium arc, longer calcium length, and greater calcium index, compared to PR or PE patients (CP vs. PR: all p < .001, CP vs. PE: all p < .001). Thin-cap fibroatheroma was less prevalent (p = .023), fibrous cap was thicker (p = .035), and mean lipid arc was narrower in CP than in PR (p < .001).
In conclusion, NCPs of CP patients had greater calcium burden and less vulnerability. This information may help to better understand the underlying mechanisms of ACS and to develop strategy for tailored management.
研究急性冠状动脉综合征（ACS）合并钙化斑块（CP）患者的非罪犯斑块（NCPs）特征。
最近，有人提出了一种针对ACS患者钙化罪犯斑块的新的体内分类方法。该组患者中NCPs的特征尚不清楚。
根据罪犯斑块表型，对492例ACS患者的692个NCPs进行回顾性比较：71个来自CP患者，383个来自斑块破裂（PR）患者，238个来自斑块侵蚀（PE）患者。
与PR或PE患者相比，CP患者的NCPs具有更大的最大钙化厚度、更宽的钙化弧、更长的钙化长度和更大的钙化指数（CP与PR比较：所有p <.001；CP与PE比较：所有p <.001）。薄帽纤维粥样瘤的发生率较低（p = 0.023），纤维帽更厚（p = 0.035），CP患者的平均脂质弧比PR患者更窄（p <.001）。
总之，CP患者的NCPs具有更大的钙负荷和更低的易损性。这些信息可能有助于更好地理解ACS的潜在机制，并制定针对性的管理策略。
