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Plaque Characteristics and Ruptured Plaque Location according to Lesion Geometry in Culprit Lesions of ST-Segment Elevation Myocardial Infarction

BACKGROUND AND OBJECTIVES: The correlations between plaque characteristics and plaque rupture location according to segmental lesion analysis have not been well defined. The aim of this study was to assess those characteristics of ST-segment elevation myocardial infarction (STEMI) culprit lesions ac...

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Autores principales: Chung, Ju-Hyun, Lee, Joo Myung, Her, Ae-Young, Cho, Heeyoun, Doh, Joon-Hyung, Nam, Chang-Wook, Kim, Hyung Il, Koo, Bon-Kwon, Shin, Eun-Seok
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Cardiology 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5711683/
https://www.ncbi.nlm.nih.gov/pubmed/29171212
http://dx.doi.org/10.4070/kcj.2017.0108
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author Chung, Ju-Hyun
Lee, Joo Myung
Her, Ae-Young
Cho, Heeyoun
Doh, Joon-Hyung
Nam, Chang-Wook
Kim, Hyung Il
Koo, Bon-Kwon
Shin, Eun-Seok
author_facet Chung, Ju-Hyun
Lee, Joo Myung
Her, Ae-Young
Cho, Heeyoun
Doh, Joon-Hyung
Nam, Chang-Wook
Kim, Hyung Il
Koo, Bon-Kwon
Shin, Eun-Seok
author_sort Chung, Ju-Hyun
collection PubMed
description BACKGROUND AND OBJECTIVES: The correlations between plaque characteristics and plaque rupture location according to segmental lesion analysis have not been well defined. The aim of this study was to assess those characteristics of ST-segment elevation myocardial infarction (STEMI) culprit lesions according to segmental lesion geometry using virtual histology intravascular ultrasound (VH-IVUS). METHODS: Sixty single discrete lesions found in the left anterior descending (LAD) coronary arteries of 60 patients with STEMI were included. Each lesion was divided into 3 segments based on lumen area (LA) index, calculated by dividing the lesion LA by the reference LA. RESULTS: Among the 3 segments, the mid-segment showed the highest proportion of necrotic core (NC; proximal, mid-, and distal segments: 20.9±11.8%, 22.7±11.3%, and 17.5±11.2%, respectively, p=0.044). VH-IVUS-derived thin-cap fibroatheroma (VH-TCFA) was also more frequently found in the mid-segment than in proximal and distal segments (36.7%, 58.3%, and 16.7%, p<0.001). The mid-segment also showed the highest prevalence of plaque rupture (45.0%, 78.3% and 11.7%, p<0.001) and thrombus (61.7%, 95.0%, and 41.7%, p<0.001) compared to proximal or distal segments. When the lesions were divided into 2 groups according to the median value (4.0 mm(2)) of minimum lumen area (MLA), plaque rupture at the distal segment was observed only in high MLA lesions (23.3% vs. 0.0%, p=0.011). CONCLUSION: Analysis of longitudinal lesion geometry using the LA index can be useful in evaluating plaque vulnerability and the incidence of plaque rupture and thrombus in STEMI patients.
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spelling pubmed-57116832017-12-05 Plaque Characteristics and Ruptured Plaque Location according to Lesion Geometry in Culprit Lesions of ST-Segment Elevation Myocardial Infarction Chung, Ju-Hyun Lee, Joo Myung Her, Ae-Young Cho, Heeyoun Doh, Joon-Hyung Nam, Chang-Wook Kim, Hyung Il Koo, Bon-Kwon Shin, Eun-Seok Korean Circ J Original Article BACKGROUND AND OBJECTIVES: The correlations between plaque characteristics and plaque rupture location according to segmental lesion analysis have not been well defined. The aim of this study was to assess those characteristics of ST-segment elevation myocardial infarction (STEMI) culprit lesions according to segmental lesion geometry using virtual histology intravascular ultrasound (VH-IVUS). METHODS: Sixty single discrete lesions found in the left anterior descending (LAD) coronary arteries of 60 patients with STEMI were included. Each lesion was divided into 3 segments based on lumen area (LA) index, calculated by dividing the lesion LA by the reference LA. RESULTS: Among the 3 segments, the mid-segment showed the highest proportion of necrotic core (NC; proximal, mid-, and distal segments: 20.9±11.8%, 22.7±11.3%, and 17.5±11.2%, respectively, p=0.044). VH-IVUS-derived thin-cap fibroatheroma (VH-TCFA) was also more frequently found in the mid-segment than in proximal and distal segments (36.7%, 58.3%, and 16.7%, p<0.001). The mid-segment also showed the highest prevalence of plaque rupture (45.0%, 78.3% and 11.7%, p<0.001) and thrombus (61.7%, 95.0%, and 41.7%, p<0.001) compared to proximal or distal segments. When the lesions were divided into 2 groups according to the median value (4.0 mm(2)) of minimum lumen area (MLA), plaque rupture at the distal segment was observed only in high MLA lesions (23.3% vs. 0.0%, p=0.011). CONCLUSION: Analysis of longitudinal lesion geometry using the LA index can be useful in evaluating plaque vulnerability and the incidence of plaque rupture and thrombus in STEMI patients. The Korean Society of Cardiology 2017-11 2017-10-26 /pmc/articles/PMC5711683/ /pubmed/29171212 http://dx.doi.org/10.4070/kcj.2017.0108 Text en Copyright © 2017. The Korean Society of Cardiology https://creativecommons.org/licenses/by-nc/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Chung, Ju-Hyun
Lee, Joo Myung
Her, Ae-Young
Cho, Heeyoun
Doh, Joon-Hyung
Nam, Chang-Wook
Kim, Hyung Il
Koo, Bon-Kwon
Shin, Eun-Seok
Plaque Characteristics and Ruptured Plaque Location according to Lesion Geometry in Culprit Lesions of ST-Segment Elevation Myocardial Infarction
title Plaque Characteristics and Ruptured Plaque Location according to Lesion Geometry in Culprit Lesions of ST-Segment Elevation Myocardial Infarction
title_full Plaque Characteristics and Ruptured Plaque Location according to Lesion Geometry in Culprit Lesions of ST-Segment Elevation Myocardial Infarction
title_fullStr Plaque Characteristics and Ruptured Plaque Location according to Lesion Geometry in Culprit Lesions of ST-Segment Elevation Myocardial Infarction
title_full_unstemmed Plaque Characteristics and Ruptured Plaque Location according to Lesion Geometry in Culprit Lesions of ST-Segment Elevation Myocardial Infarction
title_short Plaque Characteristics and Ruptured Plaque Location according to Lesion Geometry in Culprit Lesions of ST-Segment Elevation Myocardial Infarction
title_sort plaque characteristics and ruptured plaque location according to lesion geometry in culprit lesions of st-segment elevation myocardial infarction
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5711683/
https://www.ncbi.nlm.nih.gov/pubmed/29171212
http://dx.doi.org/10.4070/kcj.2017.0108
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