A Three-Vessel Virtual Histology Intravascular Ultrasound Analysis of Frequency and Distribution of Thin-Cap Fibroatheromas in Patients With Acute Coronary Syndrome or Stable Angina Pectoris

• Published in: The American journal of cardiology 2008-03, Vol.101 (5), p.568-572
• Main Authors: Hong, Myeong-Ki, MD, PhD, Mintz, Gary S., MD, Lee, Cheol Whan, MD, PhD, Lee, Jeong-Woo, MD, Park, Jae-Hyoung, MD, Park, Duk-Woo, MD, PhD, Lee, Seung-Whan, MD, PhD, Kim, Young-Hak, MD, PhD, Cheong, Sang-Sig, MD, PhD, Kim, Jae-Joong, MD, PhD, Park, Seong-Wook, MD, PhD, Park, Seung-Jung, MD, PhD
• Format: Article
• Language: English
• Subjects: Acute Coronary Syndrome - diagnostic imaging; Angina pectoris; Angina Pectoris - diagnostic imaging; Biological and medical sciences; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Coronary Artery Disease - diagnostic imaging; Coronary heart disease; Coronary Vessels - diagnostic imaging; Female; Heart; Histology; Humans; Male; Medical sciences; Middle Aged; Myocarditis. Cardiomyopathies; Rupture, Spontaneous; Ultrasonic imaging; Ultrasonography, Interventional
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2007.09.113

The frequency and distribution of thin-cap fibroatheromas (TCFA) have important clinical implications. We evaluated the frequency and distribution of TCFA identified by virtual histology intravascular ultrasound (VH-IVUS) in acute coronary syndrome (ACS) and stable angina pectoris (SAP). Preintervention 3-vessel VH-IVUS was performed in 105 patients with ACS and 107 with SAP. The length of left anterior descending artery imaged was 72 ± 16 mm—54 ± 12 mm in the left circumflex and 92 ± 19 mm in the right coronary. VH-IVUS-derived TCFA (VH-TCFA) had a necrotic core ≥10% of plaque area without overlying fibrous tissue in a plaque burden ≥40%. There were 76 ruptured plaques (55 in ACS and 21 in SAP) and 439 VH-TCFA (262 in ACS and 177 in SAP, 2.5 ± 1.5 vs 1.7 ± 1.1 TCFA per patient with ACS and with SAP, respectively; p