Presentations of acute coronary syndrome related to coronary lesion morphologies as assessed by intravascular ultrasound and optical coherence tomography

被引:25
|
作者
Kato, Masaya [1 ]
Dote, Keigo [1 ]
Sasaki, Shota [1 ]
Kagawa, Eisuke [1 ]
Nakano, Yoshinori [1 ]
Watanabe, Yoshikazu [1 ]
Higashi, Akifumi [1 ]
Itakura, Kiho [1 ]
Ochiumi, Yusuke [1 ]
Takiguchi, Yu [1 ]
机构
[1] Hiroshima City Asa Hosp, Dept Cardiol, Hiroshima 7310293, Japan
关键词
Acute coronary syndrome; Intravascular ultrasound; Optical coherence tomography; Metabolic syndrome; ACUTE MYOCARDIAL-INFARCTION; ARTERY DISEASE; PLAQUE EROSION; THROMBOLYSIS; ANGIOGRAPHY; PROGRESSION; THROMBUS; THERAPY;
D O I
10.1016/j.ijcard.2011.09.032
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Pathologically, the lesions responsible for acute coronary syndrome (ACS) are ruptures of vulnerable plaques (and occasionally fibrous-cap erosions or calcified nodules) with a superimposed thrombosis. We aimed to clarify the clinical presentations related to the morphologies of coronary lesions of ACS using intravascular ultrasound (IVUS) and optical coherence tomography (OCT). Methods and results: Seventy-five culprit lesions of ACS patients were clearly assessed with IVUS and OCT. Patients were classified into two groups based on the presence or absence of a rupture of a culprit plaque as identified by OCT. Clinical characteristics and lesion morphologies were compared between the two groups. Waist circumference was significantly greater (p<0.02) and prevalence of the metabolic syndrome (MS) higher(p = 0.0011) in the rupture group. The prevalence of prodromal angina was higher in patients without plaque ruptures (p<0.0001). Using multivariate analysis, the MS and prodromal angina were independent predictors of rupture of a culprit coronary plaque (odds ratio (OR): 27.30, p<0.003 and OR: 0.04, p = 0.0004, respectively). Among the components of the MS, the prevalence of abdominal obesity was a significant independent predictor of rupture of a culprit plaque (OR: 4.24, p<0.02). Conclusions: There are two presentations related to the coronary lesion morphologies of ACS: we should understand these aspects of ACS. (c) 2011 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:506 / 511
页数:6
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