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The relationship between volumetric plaque components and classical cardiovascular risk factors and the metabolic syndrome a 3-vessel coronary artery virtual histology-intravascular ultrasound analysis.

Authors
Zheng, M; Choi, SY; Tahk, SJ; Lim, HS; Yang, HM; Choi, BJ; Yoon, MH; Park, JS; Hwang, GS; Shin, JH
Citation
JACC. Cardiovascular interventions, 4(5):503-510, 2011
Journal Title
JACC. Cardiovascular interventions
ISSN
1936-87981876-7605
Abstract
OBJECTIVES: The aim of this study was to analyze volumetric plaque composition of the coronary arterial tree according to the classical cardiovascular risk factors and metabolic syndrome (MS) using virtual histology-intravascular ultrasound (VH-IVUS).



BACKGROUND: It remains unclear how the cardiovascular risk factors correlate with the histological components of coronary plaques.



METHODS: "Whole vessel" VH-IVUS analysis was performed in 189 vessels of 63 patients. The components of atherosclerotic plaques were classified as fibrous, fibrofatty, necrotic core (NC), and dense calcium. Quantitative assessment of these plaque components and the presence of VH-IVUS-derived thin-cap fibroatheroma in the coronary arterial trees were compared with cardiovascular risk factors.



RESULTS: There was a significantly larger mean plaque-plus-media burden in patients with diabetes mellitus (DM) (47 ± 5% vs. 39 ± 7% in non-DM patients, p < 0.001) and MS (47 ± 4% vs. 39 ± 7% in non-MS patients, p < 0.001). DM patients had a significantly larger %NC (17.8 ± 5.6% vs. 12.5 ± 6.1%, p = 0.003) compared with non-DM patients; and MS patients had a significantly larger %NC (17.3 ± 5.8% vs. 12.8 ± 6.2%, p = 0.016) as compared to non-MS patients. Finally, VH-IVUS-derived thin-cap fibroatheromas were more frequent in DM patients (3.4 ± 2.0 vs. 2.1 ± 1.7 in non-DM patients, p = 0.016) and in MS patients (4.1 ± 2.1 vs. 1.9 ± 1.4 in non-MS patients, p = 0.001).



CONCLUSIONS: Three-vessel VH-IVUS analysis showed that DM and MS patients, compared to patients without DM or MS, had a larger plaque-plus-media burden, larger amount of NC, and more frequent VH-IVUS-derived thin-cap fibroatheromas in coronary arterial trees, implying greater plaque vulnerability in DM and MS patients.
MeSH terms
AgedChi-Square DistributionCoronary Stenosis/etiology/*ultrasonographyCoronary Vessels/*ultrasonographyDiabetes Complications/etiology/*ultrasonographyFemaleHumans*Image Interpretation, Computer-Assisted*Imaging, Three-DimensionalMaleMetabolic Syndrome X/*complicationsMiddle AgedPlaque, Atherosclerotic/etiology/*ultrasonographyPredictive Value of TestsProspective StudiesRegression AnalysisRepublic of KoreaRisk AssessmentRisk FactorsSeverity of Illness Index*Ultrasonography, Interventional
DOI
10.1016/j.jcin.2010.12.015
PMID
21596322
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
AJOU Authors
최, 소연탁, 승제임, 홍석양, 형모최, 병주윤, 명호박, 진선황, 교승신, 준한
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