Coronary plaque composition of nonculprit lesions, assessed by in vivo intracoronary ultrasound radio frequency data analysis, is related to clinical presentation

• Published in: The American heart journal Vol. 151; no. 5; pp. 1020 - 1024
• Main Authors: Rodriguez-Granillo, Gastón A., Mc Fadden, Eugène P., Valgimigli, Marco, van Mieghem, Carlos A.G., Regar, Evelyn, de Feyter, Pim J., Serruys, Patrick W.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.05.2006; Elsevier; Elsevier Limited
• Subjects: Acute coronary syndromes; Aged; Atherosclerosis; Biological and medical sciences; C-Reactive Protein - metabolism; Cardiology. Vascular system; Cardiovascular disease; Catheters; Coronary Artery Disease - complications; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - metabolism; Coronary heart disease; Coronary vessels; Coronary Vessels - diagnostic imaging; Coronary Vessels - metabolism; Coronary Vessels - physiopathology; Data analysis; Diabetes; Female; Heart; Heart attacks; Histology; Humans; Lipid Metabolism; Lipids; Male; Medical sciences; Middle Aged; Myocardial Ischemia - complications; Population; Severity of Illness Index; Software; Studies; Ultrasonography, Interventional - methods; Volcanoes; Sonography; Data analysis; Composition; Coronary artery; Cardiovascular disease; Coronary heart disease; Phlebology; In vivo; Symptomatology; Phenotype; Frequency; Circulatory system; Lesion; Cardiology; Ultrasound
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/j.ahj.2005.06.040

Identification of subclinical high-risk plaques is potentially important because they may have greater likelihood of rupture and subsequent thrombosis. The purpose of this study was to assess the relationship between plaque composition determined by intravascular ultrasound (IVUS) radio frequency (RF) data analysis and clinical presentation. In 55 patients, a nonculprit vessel with <50% diameter stenosis was studied with IVUS. Tissue maps were reconstructed from RF data using IVUS–Virtual Histology software. Mean percentage of the different plaque components were 0.99% ± 0.9%, calcium; 68.04% ± 9.8%, fibrous; 19.31% ± 7.3%, fibrolipidic; and 9.43% ± 6.6%, lipid core. Mean lipid core percentage was significantly larger in patients with acute coronary syndrome (ACS) when compared with stable patients (12.26% ± 7.0% vs 7.40% ± 5.5%, P = .006). In addition, stable patients showed more fibrotic vessels (70.97% ± 9.3% vs 63.96% ± 9.1%, P = .007). There was no significant difference for either mean calcium (1.20% ± 1.1% vs 0.83% ± 0.7%, P = .124) or fibrolipidic (20.57% ± 6.9% vs 18.40% ± 7.6%, P = .281) percentages in ACS and stable patients, respectively. Vessel area obstruction did not differ between groups (46.49% ± 10.9% vs 42.83% ± 11.8%, P = .221). There was a significant, albeit weak, positive correlation between lipid core percentage and stenosis severity as determined by vessel area obstruction ( r = 0.34, P = .015). In this study, plaque characterization of nonculprit vessels using spectral analysis of IVUS RF data analysis was significantly related to clinical presentation. Percentage of lipid core, a feature related to acute coronary events and worse prognosis, was significantly larger in patients with ACS. Conversely, stable patients showed more fibrotic content.