Key result
Nonculprit ruptured plaques show ~140% higher healing rates after 12 months compared to earlier.
Why the study?
No detailed follow-up studies of ruptured plaques in nonculprit coronary lesions have been reported despite the established concept of multiple coronary plaque ruptures.
Observational (n=30)
Ruptured plaques in nonculprit lesions tend to heal slowly with a progression of angiographic stenosis, and serum CRP levels may reflect the disease activity of these plaque ruptures.
OBJECTIVES: Changes of ruptured plaques in nonculprit lesions were evaluated using coronary angioscopy. BACKGROUND: The concept of multiple coronary plaque ruptures has been established. However, no detailed follow-up studies of ruptured plaques in nonculprit lesions have yet been reported. METHODS: Forty-eight thrombi in 50 ruptured coronary plaques in nonculprit lesions in 30 patients were identified by angioscopy. The percent diameter stenosis (%DS) at the target plaques on quantitative coronary angiographic analysis and the serum C-reactive protein (CRP) level were measured. RESULTS: The mean angioscopic follow-up period was 13 +/- 9 months. Thirty-five superimposed thrombi still remained at follow-up, and the predominant thrombus color changed from red (56%) at baseline to pinkish-white (83%) at follow-up. The healing rate increased according to the angioscopic follow-up period (23% at </=12 months vs. 55% at >12 months, p = 0.044). The %DS at the healed plaque increased from baseline to follow-up (12.3 +/- 5.8% vs. 22.7 +/- 11.6%, respectively; p = 0.0004). The serum CRP level in patients with healed plaques (n = 10) was lower than that in those without healed plaques (n = 19; 0.07 +/- 0.03 mg/dl vs. 0.15 +/- 0.11 mg/dl, respectively; p = 0.007). CONCLUSIONS: The present study demonstrated that: 1) ruptured plaques in nonculprit lesions tend to heal slowly with a progression of angiographic stenosis; and 2) the serum CRP level might reflect the disease activity of the plaque ruptures.
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Takano et al. (2005) conducted an observational in Ruptured coronary plaques in nonculprit lesions (n=30). Follow-up duration >12 months vs. Follow-up duration ≤12 months was evaluated on Plaque healing rate (p=0.044). Ruptured plaques in nonculprit lesions healed more frequently after 12 months compared to within 12 months (55% vs 23%, p=0.044), and healing was associated with progression of angiographic stenosis.
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