Purpose
Myocardial infarction and sudden cardiac dearth are the first manifestation of coronary atherosclerosis in 50% of men and 64% of women in the world [].
The common reason of acute coronary events is intracoronary thrombosis [].
However the mechanism of thrombosis may be different and depend on the structure of coronary plaques.
According to plaque classification (AHA) thin-cap fibroatheroma (TCFA) is the type of plaques that is prone to rupture.
These plaques are commonly called vulnerable plaques.
Some invasive methods (intravascular ultrasound - IVUS,
optical...
Methods and Materials
CTCA and IVUS were performed in 37 patients with ACS (mean age 58 [44; 65] years,
29 men,
8 women,
25 with unstable angina,
12 with NSTE myocardial infarction) during the same hospitalization.
64 CT-scanner and IVUS (40 MHz) with automatic pull back were used for visualization of coronary walls.
First of all according to CTCA results all calcified plaques were excluded from further analysis because of the most of known CTCA-signs of vulnerable plaques are unavailable for detection in calcified plaques.
Sixty soft and...
Results
Plaque type IVUS
SRP (n=28)
SNP (n=32)
P
Fibrous plaque
1 (3,6%)
1 (3,1%)
-
Thick-cap fibroatheroma
2 (7,2%)
8 (25%)
0,09
TCFA
8 (28,5%)
12 (37,5%)
0,58
Ruptured plaque
15 (53,8%)
10 (31,2%)
0,12
Calcified fibroatheroma
0
1 (3,1%)
-
Spontaneous dissection
1 (3,6%)
0
-
Intramural hematoms
1 (3,6%)
0
-
Table 1.
IVUS.
Plaque types - SRP and SNP.
There were no significant differences in the incidence of all plaques types in SRP an SNP with IVUS (Table 1).
Plaque characteristics CTCA...
Conclusion
According to IVUS there were no significant differences in the incidence of all plaque types,
including TCFA and ruptured plaques among the SRP and SNP groups in patients with ACS,
that indicate the generalization of vulnerability in all coronary tree.
There was no differences in the most of CTCA characteristics among SRP and SNP.
The reasons of high frequency of irregular plaque surface and “nupking-ring” in SRP requires further study.