Key result
Intermediate coronary lesions in culprit vessels had higher lipidic content (P<0.001), whereas lesions in non-culprit vessels were more calcific (P<0.001) in patients with NSTE-ACS.
Why the study?
Do IVUS tissue characteristics differ between intermediate coronary lesions in culprit versus non-culprit vessels in patients with NSTE-ACS?
Cross-Sectional (n=28)
Do IVUS tissue characteristics differ between intermediate coronary lesions in culprit versus non-culprit vessels in patients with NSTE-ACS?
p-value: p=<0.001
In patients with NSTE-ACS, IVUS imaging demonstrates that intermediate lesions in culprit vessels are predominantly lipid-rich, while those in non-culprit vessels are more calcified.
Should not yet change NSTE-ACS lesion assessment; hypothesis-generating for compositional differences in culprit vs non-culprit vessels.
Disruption of vulnerable plaques is the most common cause of acute coronary syndromes. Intravascular ultrasound facilitates cross-sectional imaging of coronary arteries. We aimed at using IVUS to investigate the morphology and tissue characteristics of atherosclerotic plaques of non-culprit intermediate coronary lesions in non-ST elevation ACS setting. IVUS assessment of sixty-one intermediate coronary lesions in twenty-eight patients with the diagnosis of Non ST elevation acute coronary syndromes. Ultrasound signals were obtained by an IVUS system using a 40-MHz catheter. Mean age was 53.2 ± 9.1 years. Males = 20 (71.4%). Smoking in 17 (60.7%), hypertension in 16 (57.1%), Dyslipidemia in 12 (42.9%) and DM in 8 (28.6%). Culprit vessels represent 42% of affected vessels. Sixty-one intermediate lesions were detected. Twenty-nine lesions in culprit vessels and thirty-two lesions in non-culprit vessels with higher lipidic content in lesions of culprit vessels (P < 0.001) while a higher calcific content in lesions of non-culprit vessels (P < 0.001). Higher calcific content of proximal more than distal lesions (P = 0.048). Negative remodeling in 55.7% of lesions. A higher lipidic content in lesions of culprit vessels, while the lesions of non-culprit vessels were more calcific. Higher calcific content of proximal more than distal lesions was defined as well.
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El-Ghawaby et al. (2017) conducted a cross-sectional in Non ST elevation acute coronary syndromes (n=28). Culprit vessel lesions vs. Non-culprit vessel lesions was evaluated on Lipidic and calcific content (p=<0.001). Intermediate coronary lesions in culprit vessels had higher lipidic content (P<0.001), whereas lesions in non-culprit vessels were more calcific (P<0.001) in patients with NSTE-ACS.
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