Coronary plaque composition of culprit lesions assessed by virtual histology intravascular ultrasound in acute coronary syndrome and stable angina

We studied the composition of coronary plaque using virtual histology intravascular ultrasound (VH-IVUS) in patients with acute coronary syndrome (ACS) and stable angina pectoris (SAP). Target population consisted of 30 culprit lesions in 28 ACS patients and 20 lesions in 19 SAP patients, and tissue maps were reconstructed using VH-IVUS. Vessel, lumen and plaque areas, and percent vessel stenosis were not different between both groups. Although fibrous, fibro-fatty, and dense calcium areas of plaque were not different in the two groups, necrotic core area was significantly larger in the ACS than in the SAP group (1.59 +/- 1.05 vs. 0.80 +/- 0.57 mm(2), p<0.01). Since VH-IVUS provides information on plaque composition, this modality serves as a useful clinical tool for determining therapeutic strategy in patients with coronary disease.