Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan; Division of Cardiology, Department of Medicine, Showa University Fujigaoka Hospital, Kanagawa, Japan.
Division of Cardiology, Department of Medicine, Showa University Fujigaoka Hospital, Kanagawa, Japan.
Atherosclerosis. 2022 Nov;360:47-52. doi: 10.1016/j.atherosclerosis.2022.07.008. Epub 2022 Jul 21.
Pathological reports have shown that plaque erosion (PE), a common cause of acute coronary syndrome (ACS), can form in both fibrous plaque and lipid-rich plaque (LRP). In plaque rupture (PR), which is the main cause of ACS, the underlying plaque is LRP with a thin fibrous cap. In this study, we aimed to investigate the clinical features and lipid profiles of PE with or without LRP in comparison with those of PR.
A total of 166 patients with ACS, who underwent percutaneous coronary intervention using optical coherence tomography (OCT) and met the criteria for PR or PE, were included. LRP was defined as plaque with a maximal lipid arc (>180°). Culprit lesions were categorized into PR and PE with/without LRP [PE or PE].
The prevalence of PR, PE, and PE was 104 (62.7%), 43 (25.9%), and 19(11.4%), respectively. The patients with PR and PE had a significantly higher peak creatine kinase level (1338 and 1584U/L, respectively, p < 0.01) and prevalence of ST-elevation myocardial infarction (71.2% and 79.1%, respectively, p < 0.01) than those with PE (214U/L and 21.1%, respectively). The various lipid profiles were mostly comparable between the patients with PE and PR, but different in those with PE. The levels of small dense low-density lipoprotein cholesterol were significantly higher in the patients with PR and PE than in those with PE (39.0, 35.3, and 25.7 mg/dL, respectively, p = 0.02).
The clinical features and lipid profiles are substantially different between PE and PE, but are somewhat similar between PE and PR.
病理学报告显示，斑块侵蚀（PE）是急性冠状动脉综合征（ACS）的常见原因，可在纤维斑块和富含脂质的斑块（LRP）中形成。在ACS 的主要原因——斑块破裂（PR）中，潜在斑块是 LRP 伴薄纤维帽。本研究旨在比较 PE 有无 LRP 与 PR 的临床特征和血脂谱。
共纳入 166 例接受经皮冠状动脉介入治疗（光学相干断层扫描（OCT））且符合 PR 或 PE 标准的 ACS 患者。LRP 定义为最大脂质弧（>180°）的斑块。罪犯病变分为 PR 和 PE 伴/不伴 LRP [PE 或 PE]。
PR、PE 和 PE 的患病率分别为 104 例（62.7%）、43 例（25.9%）和 19 例（11.4%）。与 PE 相比，PR 和 PE 患者的肌酸激酶峰值水平（分别为 1338 和 1584U/L，p<0.01）和 ST 段抬高型心肌梗死的患病率（分别为 71.2%和 79.1%，p<0.01）更高。PE 与 PR 患者的各种血脂谱大多相似，但与 PE 患者不同。PR 和 PE 患者的小而密 LDL 胆固醇水平明显高于 PE 患者（分别为 39.0、35.3 和 25.7mg/dL，p=0.02）。
PE 与 PE 之间的临床特征和血脂谱有很大差异，但与 PR 之间的血脂谱有些相似。
