Morphology of vulnerable coronary plaque: insights from follow-up of patients examined by intravascular ultrasound before an acute coronary syndrome

We examined 114 coronary sites without significant stenosis by angiography in 106 patients

Masakazu Yamagishi; Mitsuyasu Terashima; Kojiro Awano; Mikihiro Kijima; Satoshi Nakatani; Satoshi Daikoku; Kenichi Ito; Yoshio Yasumura; Kunio Miyatake

2002

Scholarcy highlights

  • Clinical evaluation of the vulnerable atherosclerotic plaque is important, few data exist regarding the morphology of the vulnerable plaque in clinical settings
  • To determine the morphologic features of coronary plaques associated with acute coronary syndrome, we prospectively followed patients with atherosclerotic disease identified by intravascular ultrasound
  • We examined 114 coronary sites without significant stenosis by angiography in 106 patients
  • All the preexisting plaques related to the acute events exhibited an eccentric pattern and the mean percent plaque area was 67 ± 9%, which was greater than plaque area in the other 90 patients without acute events
  • Large eccentric plaque containing an echolucent zone by IVUS can be at increased risk for instability even though the lumen area is preserved at the time of initial study
  • Compensatory enlargement of vessel wall due to remodeling may contribute to the relatively small degree of stenosis by angiography

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