European Heart Journal Advance Access originally published online on July 13, 2006
European Heart Journal 2006 27(16):1921-1927; doi:10.1093/eurheartj/ehl104
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Global characterization of coronary plaque rupture phenotype using three-vessel intravascular ultrasound radiofrequency data analysis
Department of Cardiology of the Thoraxcenter, Erasmus MC, Bd-406, Dr Molewaterplein 40, PO Box 1738, 3015-GD Rotterdam, The Netherlands
Received 12 December 2005; revised 5 May 2006; accepted 26 May 2006; online publish-ahead-of-print 13 July 2006.
* Corresponding author. Tel: +31 10 4635260; fax: +31 10 4369154. E-mail address: p.w.j.c.serruys{at}erasmusmc.nl
See page 1889 for the editorial comment on this article (doi:10.1093/eurheartj/ehl129)
Aims To compare the global characteristics of patients with and without evidence of plaque rupture (PR) in their coronary tree and to evaluate the phenotype of ruptured plaques using intravascular ultrasound (IVUS) radiofrequency data analysis (IVUS-VH).
Methods and results Forty patients underwent three-vessel IVUS-VH interrogation. Twenty-eight PRs were diagnosed in 26 vessels (25.7% of the vessels studied) of 20 patients (50% of the population). Ruptures located in the left anterior descending were clustered in the proximal part of the vessel, whereas ruptures located in the right coronary artery were more distally located (P=0.02). Patients with at least one PR presented larger body mass index (BMI) (28.4±3.7 vs. 25.8±2.6 kg/m2, P=0.01) and plaque burden (40.7±7.6 vs. 33.7±8.4%, P=0.01) than patients without rupture, despite showing similar lumen cross-sectional area (9.6±3.3 vs. 9.2±2.3 mm2, P=0.60). Among current smokers, 66.7% presented a PR in their coronary tree. Finally, PR sites showed a higher content of necrotic core compared with minimum lumen area sites (17.48±10.8 vs. 13.10±6.5%, P=0.03) and a trend towards higher calcified component.
Conclusion Patients with at least one PR in their coronary tree presented larger BMI and worse IVUS-derived characteristics compared with patients without PR.
Key Words: Plaque rupture • Ultrasonography • Atherosclerosis • Vulnerable plaque
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