经皮冠状动脉血管镜对稳定型心绞痛患者急性冠状动脉综合征的预测

Prediction of acute coronary syndromes by percutaneous coronary angioscopy in patients with stable angina.

作者信息

Uchida Y, Nakamura F, Tomaru T, Morita T, Oshima T, Sasaki T, Morizuki S, Hirose J

机构信息

Second Department of Internal Medicine, University of Tokyo, Japan.

出版信息

Am Heart J. 1995 Aug;130(2):195-203. doi: 10.1016/0002-8703(95)90429-8.

DOI:10.1016/0002-8703(95)90429-8

PMID:7631596

Abstract

To pinpoint the link between plaque characteristics and acute coronary syndromes, we performed a 12-month prospective follow-up study in 157 patients with stable angina pectoris in whom regular coronary plaques were observed by percutaneous coronary angioscopy. Acute coronary syndromes occurred more frequently in patients with yellow plaque than in those with white plaques (11 of 39 vs 4 of 118; p = 0.00021). Moreover, the syndromes occurred more frequently in patients with glistening yellow plaques than in those with nonglistening yellow plaques (9 of 13 vs 2 of 26; p = 0.00026). Thrombus arising from the ruptured identical plaques was confirmed by angioscopy as the culprit lesion of the syndromes. The results indicate that acute coronary syndromes occur frequently and in a short time in patients with glistening yellow plaques and that angioscopy but not angiography is feasible for prediction of the syndromes.

摘要

为明确斑块特征与急性冠状动脉综合征之间的联系，我们对157例稳定型心绞痛患者进行了为期12个月的前瞻性随访研究，这些患者经皮冠状动脉血管镜检查发现有规则的冠状动脉斑块。急性冠状动脉综合征在黄色斑块患者中比白色斑块患者更频繁发生（39例中有11例，118例中有4例；p = 0.00021）。此外，急性冠状动脉综合征在有光泽黄色斑块患者中比无光泽黄色斑块患者更频繁发生（13例中有9例，26例中有2例；p = 0.00026）。血管镜检查证实，由破裂的相同斑块形成的血栓是综合征的罪魁祸首病变。结果表明，有光泽黄色斑块患者急性冠状动脉综合征频繁且在短时间内发生，血管镜而非血管造影对综合征的预测是可行的。