Background-Ruptured coronary atheromatous plaque is generally considered to i nvolve a high risk of subsequent clinical events. Few data are available on the natural evolution of non-culprit-lesionruptured plaque. We therefore used ser ial intravascular ultrasound(IVUS) to study how such lesions, detected in the co ntext of a first acute coronary syndrome with elevated troponin I levels, develo p. Methods and Results-Fourteen patients with 28 distinct plaque ruptures(2±1 per patient) without significant associated stenosis(minimal lumen cross-sectio nal area >4mm2) were included and systematically treated with 40 mg statin and a ntiplatelet agent(clopidogrel and aspirin for ≥9 months). Mean clinical and IVU S follow-up was 22±13 months(median, 22 months). No clinical event related to the lesion under study occurred. On final IVUS examination, half(14 of 28) of th e ruptured plaques had healed, and the degree of stenosis tended to diminish(ste nosis, 22±17%versus 29±17%at baseline; P=0.056). No healing-prediction crit erion could be identified. Conclusions -Nearly 2 years of follow-up found that spontaneous coronary atheromatous plaque rupture without significant stenosis d etected on first acute coronary syndrome healed without significant plaque modif ication in 50%of cases with medical therapy.
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