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Intravascular ultrasound insights into the unstable features of the coronary atherosclerotic plaques: A systematic review and meta‐analysis
Background There is a lack of a comprehensive picture of plaque geometry and composition of unstable atherosclerotic lesions as observed with intravascular ultrasound techniques. We analysed through a systematic review with meta‐analysis 39 characteristics of atherosclerotic plaques in three scenari...
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| Published in: | European journal of clinical investigation 2022-01, Vol.52 (1), p.e13671-n/a |
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| container_start_page | e13671 |
| container_title | European journal of clinical investigation |
| container_volume | 52 |
| creator | Homorodean, Calin Leucuta, Daniel‐Corneliu Ober, Mihai Homorodean, Romana Spinu, Mihail Olinic, Maria Tataru, Dan Olinic, Dan‐Mircea |
| description | Background
There is a lack of a comprehensive picture of plaque geometry and composition of unstable atherosclerotic lesions as observed with intravascular ultrasound techniques.
We analysed through a systematic review with meta‐analysis 39 characteristics of atherosclerotic plaques in three scenarios involving culprit and non‐culprit lesions from acute coronary syndromes vs stable angina pectoris patients, and culprit vs non‐culprit lesions in acute coronary syndromes patients.
Methods
A systematic search of PubMed and EMBASE, from inception to April 2020 was performed. The combined odds ratios or mean differences of all IVUS characteristics were calculated with random‐effects models.
Results
Twenty‐eight studies involving 5434 subjects, and 5618 lesions were included. Culprit lesions in acute coronary syndromes have larger plaque areas and remodeling indexes (MD = 0.13 [0.08; 0.17], p |
| doi_str_mv | 10.1111/eci.13671 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2563424250</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2614052658</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3531-24ebe8888c707b4c882b71664ca19f0829083704c420c44893788ac9b9ca6f0a3</originalsourceid><addsrcrecordid>eNp1kc9u1DAQxi0EokvhwAsgS1zgkNb_kjjcqlVpV6rEBc7RxJ1QV068eJxWe-MFkHhGngRvt3BAYg6eGfunz2N_jL2W4kSWOEXnT6RuWvmErUquK6Ub9ZSthJCmUl2rjtgLolshhJVaPWdH2hgpldUr9mMz5wR3QG4JkPgSSkdxma-5n8l_vclUihx5vkG-zJRhCMhHhLwkJB7HhwMXU5wh7TiULkVyoazZO74N8G1B-sDPOO0o4wT73YR3Hu85lEsmzPDr-0-YIezI00v2bIRA-OoxH7MvH88_ry-rq08Xm_XZVeV0rWWlDA5oS7hWtINx1qqhlU1jHMhuFFZ1wupWGGeUcMbYTrfWguuGzkEzCtDH7N1Bd5vifsDcT54chgAzxoV6VTfaKKNqUdC3_6C3cUll3kI10ohaNbUt1PsD5crzKeHYb5Ofypf0UvR7j_riUf_gUWHfPCouw4TXf8k_phTg9ADc-4C7_yv15-vNQfI3yaOdrA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2614052658</pqid></control><display><type>article</type><title>Intravascular ultrasound insights into the unstable features of the coronary atherosclerotic plaques: A systematic review and meta‐analysis</title><source>Wiley</source><creator>Homorodean, Calin ; Leucuta, Daniel‐Corneliu ; Ober, Mihai ; Homorodean, Romana ; Spinu, Mihail ; Olinic, Maria ; Tataru, Dan ; Olinic, Dan‐Mircea</creator><creatorcontrib>Homorodean, Calin ; Leucuta, Daniel‐Corneliu ; Ober, Mihai ; Homorodean, Romana ; Spinu, Mihail ; Olinic, Maria ; Tataru, Dan ; Olinic, Dan‐Mircea</creatorcontrib><description>Background
There is a lack of a comprehensive picture of plaque geometry and composition of unstable atherosclerotic lesions as observed with intravascular ultrasound techniques.
We analysed through a systematic review with meta‐analysis 39 characteristics of atherosclerotic plaques in three scenarios involving culprit and non‐culprit lesions from acute coronary syndromes vs stable angina pectoris patients, and culprit vs non‐culprit lesions in acute coronary syndromes patients.
Methods
A systematic search of PubMed and EMBASE, from inception to April 2020 was performed. The combined odds ratios or mean differences of all IVUS characteristics were calculated with random‐effects models.
Results
Twenty‐eight studies involving 5434 subjects, and 5618 lesions were included. Culprit lesions in acute coronary syndromes have larger plaque areas and remodeling indexes (MD = 0.13 [0.08; 0.17], p < 0.001) and contained larger necrotic cores (MD = 0.67 (95% CI 0.19;1.15), p = 0.006) that stable angina culprit lesions. In acute patients, culprit plaques were also more remodeled, had larger necrotic cores and had more frequently a Thin‐Cap Fibroatheroma morphology (OR = 1.79 (95% CI 1.21; 2.65), p = 0.004) than non‐culprit lesions. Non‐culprit lesions in acute syndromes were more often ruptured (OR = 2.25 (95% CI:1.05; 4.82), p = 0.037) or Thin‐Cap Fibroatheromas than in stable angina.
Conclusion
Culprit lesions from acute coronary patients are larger, more positively remodeled and contained more lipids as compared to stable angina lesions or non‐culprit in acute patients. Non culprit lesions are also more often complicated or vulnerable in acute than stable patients.</description><identifier>ISSN: 0014-2972</identifier><identifier>EISSN: 1365-2362</identifier><identifier>DOI: 10.1111/eci.13671</identifier><identifier>PMID: 34411283</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>acute coronary syndrome ; Acute coronary syndromes ; Angina ; Angina pectoris ; Arteriosclerosis ; Atherosclerosis ; Cores ; Coronary Artery Disease - diagnostic imaging ; Disorders ; Humans ; intravascular ultrasound ; Lesions ; Lipids ; Meta-analysis ; non‐culprit lesion ; plaque morphology ; Plaque, Atherosclerotic - diagnostic imaging ; Plaques ; Systematic review ; Ultrasonic imaging ; Ultrasonic methods ; Ultrasonic testing ; Ultrasonography, Interventional ; Ultrasound ; vessel remodeling</subject><ispartof>European journal of clinical investigation, 2022-01, Vol.52 (1), p.e13671-n/a</ispartof><rights>2021 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd</rights><rights>2021 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.</rights><rights>Copyright © 2022 Stichting European Society for Clinical Investigation Journal Foundation</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3531-24ebe8888c707b4c882b71664ca19f0829083704c420c44893788ac9b9ca6f0a3</citedby><cites>FETCH-LOGICAL-c3531-24ebe8888c707b4c882b71664ca19f0829083704c420c44893788ac9b9ca6f0a3</cites><orcidid>0000-0003-4218-8622</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34411283$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Homorodean, Calin</creatorcontrib><creatorcontrib>Leucuta, Daniel‐Corneliu</creatorcontrib><creatorcontrib>Ober, Mihai</creatorcontrib><creatorcontrib>Homorodean, Romana</creatorcontrib><creatorcontrib>Spinu, Mihail</creatorcontrib><creatorcontrib>Olinic, Maria</creatorcontrib><creatorcontrib>Tataru, Dan</creatorcontrib><creatorcontrib>Olinic, Dan‐Mircea</creatorcontrib><title>Intravascular ultrasound insights into the unstable features of the coronary atherosclerotic plaques: A systematic review and meta‐analysis</title><title>European journal of clinical investigation</title><addtitle>Eur J Clin Invest</addtitle><description>Background
There is a lack of a comprehensive picture of plaque geometry and composition of unstable atherosclerotic lesions as observed with intravascular ultrasound techniques.
We analysed through a systematic review with meta‐analysis 39 characteristics of atherosclerotic plaques in three scenarios involving culprit and non‐culprit lesions from acute coronary syndromes vs stable angina pectoris patients, and culprit vs non‐culprit lesions in acute coronary syndromes patients.
Methods
A systematic search of PubMed and EMBASE, from inception to April 2020 was performed. The combined odds ratios or mean differences of all IVUS characteristics were calculated with random‐effects models.
Results
Twenty‐eight studies involving 5434 subjects, and 5618 lesions were included. Culprit lesions in acute coronary syndromes have larger plaque areas and remodeling indexes (MD = 0.13 [0.08; 0.17], p < 0.001) and contained larger necrotic cores (MD = 0.67 (95% CI 0.19;1.15), p = 0.006) that stable angina culprit lesions. In acute patients, culprit plaques were also more remodeled, had larger necrotic cores and had more frequently a Thin‐Cap Fibroatheroma morphology (OR = 1.79 (95% CI 1.21; 2.65), p = 0.004) than non‐culprit lesions. Non‐culprit lesions in acute syndromes were more often ruptured (OR = 2.25 (95% CI:1.05; 4.82), p = 0.037) or Thin‐Cap Fibroatheromas than in stable angina.
Conclusion
Culprit lesions from acute coronary patients are larger, more positively remodeled and contained more lipids as compared to stable angina lesions or non‐culprit in acute patients. Non culprit lesions are also more often complicated or vulnerable in acute than stable patients.</description><subject>acute coronary syndrome</subject><subject>Acute coronary syndromes</subject><subject>Angina</subject><subject>Angina pectoris</subject><subject>Arteriosclerosis</subject><subject>Atherosclerosis</subject><subject>Cores</subject><subject>Coronary Artery Disease - diagnostic imaging</subject><subject>Disorders</subject><subject>Humans</subject><subject>intravascular ultrasound</subject><subject>Lesions</subject><subject>Lipids</subject><subject>Meta-analysis</subject><subject>non‐culprit lesion</subject><subject>plaque morphology</subject><subject>Plaque, Atherosclerotic - diagnostic imaging</subject><subject>Plaques</subject><subject>Systematic review</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonic methods</subject><subject>Ultrasonic testing</subject><subject>Ultrasonography, Interventional</subject><subject>Ultrasound</subject><subject>vessel remodeling</subject><issn>0014-2972</issn><issn>1365-2362</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp1kc9u1DAQxi0EokvhwAsgS1zgkNb_kjjcqlVpV6rEBc7RxJ1QV068eJxWe-MFkHhGngRvt3BAYg6eGfunz2N_jL2W4kSWOEXnT6RuWvmErUquK6Ub9ZSthJCmUl2rjtgLolshhJVaPWdH2hgpldUr9mMz5wR3QG4JkPgSSkdxma-5n8l_vclUihx5vkG-zJRhCMhHhLwkJB7HhwMXU5wh7TiULkVyoazZO74N8G1B-sDPOO0o4wT73YR3Hu85lEsmzPDr-0-YIezI00v2bIRA-OoxH7MvH88_ry-rq08Xm_XZVeV0rWWlDA5oS7hWtINx1qqhlU1jHMhuFFZ1wupWGGeUcMbYTrfWguuGzkEzCtDH7N1Bd5vifsDcT54chgAzxoV6VTfaKKNqUdC3_6C3cUll3kI10ohaNbUt1PsD5crzKeHYb5Ofypf0UvR7j_riUf_gUWHfPCouw4TXf8k_phTg9ADc-4C7_yv15-vNQfI3yaOdrA</recordid><startdate>202201</startdate><enddate>202201</enddate><creator>Homorodean, Calin</creator><creator>Leucuta, Daniel‐Corneliu</creator><creator>Ober, Mihai</creator><creator>Homorodean, Romana</creator><creator>Spinu, Mihail</creator><creator>Olinic, Maria</creator><creator>Tataru, Dan</creator><creator>Olinic, Dan‐Mircea</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4218-8622</orcidid></search><sort><creationdate>202201</creationdate><title>Intravascular ultrasound insights into the unstable features of the coronary atherosclerotic plaques: A systematic review and meta‐analysis</title><author>Homorodean, Calin ; Leucuta, Daniel‐Corneliu ; Ober, Mihai ; Homorodean, Romana ; Spinu, Mihail ; Olinic, Maria ; Tataru, Dan ; Olinic, Dan‐Mircea</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3531-24ebe8888c707b4c882b71664ca19f0829083704c420c44893788ac9b9ca6f0a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>acute coronary syndrome</topic><topic>Acute coronary syndromes</topic><topic>Angina</topic><topic>Angina pectoris</topic><topic>Arteriosclerosis</topic><topic>Atherosclerosis</topic><topic>Cores</topic><topic>Coronary Artery Disease - diagnostic imaging</topic><topic>Disorders</topic><topic>Humans</topic><topic>intravascular ultrasound</topic><topic>Lesions</topic><topic>Lipids</topic><topic>Meta-analysis</topic><topic>non‐culprit lesion</topic><topic>plaque morphology</topic><topic>Plaque, Atherosclerotic - diagnostic imaging</topic><topic>Plaques</topic><topic>Systematic review</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonic methods</topic><topic>Ultrasonic testing</topic><topic>Ultrasonography, Interventional</topic><topic>Ultrasound</topic><topic>vessel remodeling</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Homorodean, Calin</creatorcontrib><creatorcontrib>Leucuta, Daniel‐Corneliu</creatorcontrib><creatorcontrib>Ober, Mihai</creatorcontrib><creatorcontrib>Homorodean, Romana</creatorcontrib><creatorcontrib>Spinu, Mihail</creatorcontrib><creatorcontrib>Olinic, Maria</creatorcontrib><creatorcontrib>Tataru, Dan</creatorcontrib><creatorcontrib>Olinic, Dan‐Mircea</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of clinical investigation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Homorodean, Calin</au><au>Leucuta, Daniel‐Corneliu</au><au>Ober, Mihai</au><au>Homorodean, Romana</au><au>Spinu, Mihail</au><au>Olinic, Maria</au><au>Tataru, Dan</au><au>Olinic, Dan‐Mircea</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intravascular ultrasound insights into the unstable features of the coronary atherosclerotic plaques: A systematic review and meta‐analysis</atitle><jtitle>European journal of clinical investigation</jtitle><addtitle>Eur J Clin Invest</addtitle><date>2022-01</date><risdate>2022</risdate><volume>52</volume><issue>1</issue><spage>e13671</spage><epage>n/a</epage><pages>e13671-n/a</pages><issn>0014-2972</issn><eissn>1365-2362</eissn><abstract>Background
There is a lack of a comprehensive picture of plaque geometry and composition of unstable atherosclerotic lesions as observed with intravascular ultrasound techniques.
We analysed through a systematic review with meta‐analysis 39 characteristics of atherosclerotic plaques in three scenarios involving culprit and non‐culprit lesions from acute coronary syndromes vs stable angina pectoris patients, and culprit vs non‐culprit lesions in acute coronary syndromes patients.
Methods
A systematic search of PubMed and EMBASE, from inception to April 2020 was performed. The combined odds ratios or mean differences of all IVUS characteristics were calculated with random‐effects models.
Results
Twenty‐eight studies involving 5434 subjects, and 5618 lesions were included. Culprit lesions in acute coronary syndromes have larger plaque areas and remodeling indexes (MD = 0.13 [0.08; 0.17], p < 0.001) and contained larger necrotic cores (MD = 0.67 (95% CI 0.19;1.15), p = 0.006) that stable angina culprit lesions. In acute patients, culprit plaques were also more remodeled, had larger necrotic cores and had more frequently a Thin‐Cap Fibroatheroma morphology (OR = 1.79 (95% CI 1.21; 2.65), p = 0.004) than non‐culprit lesions. Non‐culprit lesions in acute syndromes were more often ruptured (OR = 2.25 (95% CI:1.05; 4.82), p = 0.037) or Thin‐Cap Fibroatheromas than in stable angina.
Conclusion
Culprit lesions from acute coronary patients are larger, more positively remodeled and contained more lipids as compared to stable angina lesions or non‐culprit in acute patients. Non culprit lesions are also more often complicated or vulnerable in acute than stable patients.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>34411283</pmid><doi>10.1111/eci.13671</doi><tpages>0</tpages><orcidid>https://orcid.org/0000-0003-4218-8622</orcidid></addata></record> |
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| ispartof | European journal of clinical investigation, 2022-01, Vol.52 (1), p.e13671-n/a |
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| subjects | acute coronary syndrome Acute coronary syndromes Angina Angina pectoris Arteriosclerosis Atherosclerosis Cores Coronary Artery Disease - diagnostic imaging Disorders Humans intravascular ultrasound Lesions Lipids Meta-analysis non‐culprit lesion plaque morphology Plaque, Atherosclerotic - diagnostic imaging Plaques Systematic review Ultrasonic imaging Ultrasonic methods Ultrasonic testing Ultrasonography, Interventional Ultrasound vessel remodeling |
| title | Intravascular ultrasound insights into the unstable features of the coronary atherosclerotic plaques: A systematic review and meta‐analysis |
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