Key result
Baseline plaque characteristics, including calcifications and static positive remodeling, were independent predictors of reduced subsequent arterial remodeling capacity at 12 months.
Cohort (n=138)
Baseline plaque calcifications and static positive remodeling identified by intravascular imaging can serve as morphological biomarkers to predict decreased subsequent coronary arterial remodeling.
Answers are grounded in this paper and cite their sources.
Baseline calcifications or static remodeling may limit future capacity; hypothesis-generating and requires prospective validation before practice change.
// Zulong Xie 1,2,* , Nana Dong 1,3,* , Rong Sun 1,3 , Xinxin Liu 1,3 , Xia Gu 4 , Yong Sun 1,3 , Hongwei Du 1,3 , Jiannan Dai 1,3 , Youbin Liu 1,3 , Jingbo Hou 1,3 , Jinwei Tian 1,3 and Bo Yu 1,3 1 Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China 2 Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China 3 The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China 4 Department of Cardiology, Heilongjiang Provincial Hospital, Harbin, China * These authors have contributed equally to this work Correspondence to: Jinwei Tian, email: // Bo Yu, email: // Keywords : atherosclerosis; plaque characteristics; coronary artery remodeling; optical coherence tomography; intravascular ultrasound Received : August 08, 2016 Accepted : December 07, 2016 Published : December 15, 2016 Abstract Atherosclerosis often leads to myocardial infarction and stroke. We examined the influence of baseline plaque characteristics on subsequent vascular remodeling in response to changes in plaque size. Using optical coherence tomography (OCT) and intravascular ultrasound (IVUS), we examined 213 plaques from 138 patients with acute coronary syndrome at baseline and repeated IVUS at the 12-month follow-up. The change in external elastic membrane (EEM) area for each 1 mm2 change in plaque area (i.e., the slope of the regression line) was calculated as a measure of vascular remodeling capacity. In plaques with static positive remodeling, the slope was smaller than in plaques without static positive remodeling. In addition, the slope of the regression line for lesions with a large plaque burden was much smaller than that for lesions with a small plaque burden. Multivariate linear regression analysis showed that diabetes, calcification and static positive remodeling were inversely and independently associated with the level of change in EEM area/change in plaque area. Lesions with a large plaque burden, calcifications or static positive remodeling had less remodeling capacity, and calcification and static positive remodeling were independent predictors of reduced subsequent remodeling. Therefore, calcifications and static positive remodeling could be used as morphological biomarkers to predict decreased subsequent arterial remodeling.
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Dong et al. (2016) conducted a cohort in Acute coronary syndrome (n=138). Baseline plaque characteristics (calcification, static positive remodeling, large plaque burden) vs. Plaques without these baseline characteristics was evaluated on Change in external elastic membrane (EEM) area for each 1 mm2 change in plaque area (vascular remodeling capacity). Baseline plaque characteristics, including calcifications and static positive remodeling, were independent predictors of reduced subsequent arterial remodeling capacity at 12 months.
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