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European Heart Journal Advance Access published online on July 13, 2006
European Heart Journal, doi:10.1093/eurheartj/ehl104
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European Heart Journal © The European Society of Cardiology 2006; all rights reserved
Received December 12, 2005
Revised May 5, 2006
Accepted May 26, 2006

Clinical research

Global characterization of coronary plaque rupture phenotype using three-vessel intravascular ultrasound radiofrequency data analysis

Gastón A. Rodriguez-Granillo 1, Héctor M. García-García 1, Marco Valgimigli 1, Sophia Vaina 1, Carlos van Mieghem 1, Robert J. van Geuns 1, Maarten van der Ent 1, Evelyn Regar 1, Peter de Jaegere 1, Willem van der Giessen 1, Pim de Feyter 1, and Patrick W. Serruys 1 *

1 Department of Cardiology of the Thoraxcenter, Erasmus MC, Bd-406, Dr Molewaterplein 40, PO Box 1738, 3015-GD Rotterdam, The Netherlands

* To whom correspondence should be addressed.
Patrick W. Serruys, E-mail: p.w.j.c.serruys{at}erasmusmc.nl


  Abstract

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.

Keywords: Plaque rupture; Ultrasonography; Atherosclerosis; Vulnerable plaque.
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