Association Between Virtual Histology Intravascular Ultrasound Findings and Subsequent Coronary Events in Patients With Acute Coronary Syndrome

摘要

Virtual histology intravascular ultrasound (VH-IVUS) was employed to compare coronary plaque characteristics between acute coronary syndrome (ACS) patients with and without subsequent coronary events. It is critical to predict subsequent coronary events in patients treated for ACS. Coronary artery events sometimes occur in lesions that do not receive intervention. VH-IVUS was performed in 57 patients with ACS to analyze 83 non-culprit lesions. Characteristics of plaques in the non-culprit lesions were determined. Patients were followed-up for 4.8 ± 1.8 years. During the follow-up period, ACS and stable angina pectoris occurred in 7 patients in whom 13 non-culprit lesions had been analyzed. Seventy non-culprit lesions in 50 patients who did not experience subsequent coronary events were also analyzed. Plaque area was greater in 7 patients who had subsequent coronary events than in those who did not (11.5 ± 3.1 versus 9.1 ± 3.6 mm3/mm, P = 0.03). However, there was no significant difference in plaque burden between the two groups (57.1 ± 8.9 versus 55.6 ± 8.7%, P = 0.18). Areas of dense calcium (DC) and necrotic core (NC) were greater in patients who had subsequent coronary events than in those who did not (0.6 ± 0.5 versus 0.2 ± 0.3 mm3/mm, P 3/mm, P < 0.01, respectively). When DC area was larger (≥ 3.4% of the plaque area), the cumulative coronary event rate increased significantly (28.6 versus 6.5%, P < 0.01). This was also true for NC area (≥ 20.9%, 31.4 versus 5.1%, P < 0.01). Area size of DC or NC in non-culprit plaques may be associated with subsequent coronary events in patients with ACS.