Key result
Non-culprit coronary lesions in patients with acute coronary syndrome were significantly associated with lipid-rich plaques compared to those with stable angina pectoris (OR 7.10).
Why the study?
Does acute coronary syndrome compared to stable angina pectoris associate with lipid-rich plaques in culprit and non-culprit lesions?
Observational (n=165)
Assessors blinded to patient characteristics
Does acute coronary syndrome compared to stable angina pectoris associate with lipid-rich plaques in culprit and non-culprit lesions?
Answers are grounded in this paper and cite their sources.
Non-culprit coronary lesions in patients with acute coronary syndrome are associated with lipid-rich plaques, suggesting a pan-coronary process of plaque instability.
BACKGROUND: Patients with acute coronary syndrome (ACS) have multiple complex coronary plaques associated with plaque vulnerability. The present study assessed the tissue characteristics of coronary plaques between ACS and stable angina pectoris (SAP) of culprit and non-culprit lesions using integrated backscatter intravascular ultrasound (IB-IVUS). METHODS AND RESULTS: IVUS was performed in 165 patients (40 patients with ACS) with 225 culprit (65 lesions in ACS) and 171 non-culprit lesions (42 lesions in ACS). The percentage of fibrous area (fibrous area/plaque area, %FIB) and the percentage of lipid area (lipid area/plaque area, %LIP) at the segment with minimal luminal area were calculated using IB-IVUS system. Culprit and non-culprit lesions with ACS showed a significant increase in %LIP (38±18 vs. 30±15%, P=0.002, and 38±21 vs. 32±17%, P=0.03, respectively) and a significant decrease in %FIB (59±15 vs. 63±12 %, P=0.04, and 57±18 vs. 62±14%, P=0.04, respectively) compared to those with SAP. On logistic regression analysis, not only culprit lesions but also non-culprit lesions with ACS patients were significantly associated with the lipid-rich plaque. CONCLUSIONS: Non-culprit coronary lesions with ACS patients are associated with the lipid-rich plaque, suggesting the extensive development of plaques instability in these patients.
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Ando et al. (2010) conducted an observational in Acute Coronary Syndrome and Stable Angina Pectoris (n=165). Acute coronary syndrome vs. Stable angina pectoris was evaluated on Presence of lipid-rich plaque in non-culprit lesions (OR 7.10, 95% CI 1.86-27.2, p=0.004). Non-culprit coronary lesions in patients with acute coronary syndrome were significantly associated with lipid-rich plaques compared to those with stable angina pectoris (OR 7.10).
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