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High Coronary Wall Shear Stress Worsens Plaque Vulnerability: A Systematic Review and Meta-Analysis

AIM: The aim of this meta-analysis is to assess the impact of wall shear stress (WSS) severity on arterial plaque vulnerability. METHODS: We systematically searched electronic databases and selected studies which assessed the relationship between WSS measured by intravascular ultrasound and coronary...

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Autores principales: Bajraktari, Artan, Bytyçi, Ibadete, Henein, Michael Y.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8326896/
https://www.ncbi.nlm.nih.gov/pubmed/33535802
http://dx.doi.org/10.1177/0003319721991722
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author Bajraktari, Artan
Bytyçi, Ibadete
Henein, Michael Y.
author_facet Bajraktari, Artan
Bytyçi, Ibadete
Henein, Michael Y.
author_sort Bajraktari, Artan
collection PubMed
description AIM: The aim of this meta-analysis is to assess the impact of wall shear stress (WSS) severity on arterial plaque vulnerability. METHODS: We systematically searched electronic databases and selected studies which assessed the relationship between WSS measured by intravascular ultrasound and coronary artery plaque features. In 7 studies, a total of 615 patients with 28 276 arterial segments (median follow-up: 7.71 months) were identified. At follow-up, the pooled analysis showed high WSS to be associated with regression of plaque fibrous area, weighted mean difference (WMD) −0.11 (95% CI: −0.20 to −0.02, P = .02) and fibrofatty area, WMD −0.09 (95% CI: −0.17 to −0.01, P = .02), reduction in plaque total area, WMD −0.09 (95% CI: −0.14 to −0.04, P = .007) and increased necrotic core area, and WMD 0.04 (95% CI: 0.01-0.09, P = .03) compared with low WSS. Dense calcium deposits remained unchanged in high and low WSS (0.01 vs 0.02 mm(2); P > .05). High WSS resulted in profound remodeling (40% vs 18%, P < .05) and with more constructive remodeling than low WSS (78% vs 40%, P < .01). CONCLUSIONS: High WSS in coronary arteries is associated with worsening plaque vulnerability and more profound arterial wall remodeling compared with low WSS.
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spelling pubmed-83268962021-08-09 High Coronary Wall Shear Stress Worsens Plaque Vulnerability: A Systematic Review and Meta-Analysis Bajraktari, Artan Bytyçi, Ibadete Henein, Michael Y. Angiology Review AIM: The aim of this meta-analysis is to assess the impact of wall shear stress (WSS) severity on arterial plaque vulnerability. METHODS: We systematically searched electronic databases and selected studies which assessed the relationship between WSS measured by intravascular ultrasound and coronary artery plaque features. In 7 studies, a total of 615 patients with 28 276 arterial segments (median follow-up: 7.71 months) were identified. At follow-up, the pooled analysis showed high WSS to be associated with regression of plaque fibrous area, weighted mean difference (WMD) −0.11 (95% CI: −0.20 to −0.02, P = .02) and fibrofatty area, WMD −0.09 (95% CI: −0.17 to −0.01, P = .02), reduction in plaque total area, WMD −0.09 (95% CI: −0.14 to −0.04, P = .007) and increased necrotic core area, and WMD 0.04 (95% CI: 0.01-0.09, P = .03) compared with low WSS. Dense calcium deposits remained unchanged in high and low WSS (0.01 vs 0.02 mm(2); P > .05). High WSS resulted in profound remodeling (40% vs 18%, P < .05) and with more constructive remodeling than low WSS (78% vs 40%, P < .01). CONCLUSIONS: High WSS in coronary arteries is associated with worsening plaque vulnerability and more profound arterial wall remodeling compared with low WSS. SAGE Publications 2021-02-04 2021-09 /pmc/articles/PMC8326896/ /pubmed/33535802 http://dx.doi.org/10.1177/0003319721991722 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review
Bajraktari, Artan
Bytyçi, Ibadete
Henein, Michael Y.
High Coronary Wall Shear Stress Worsens Plaque Vulnerability: A Systematic Review and Meta-Analysis
title High Coronary Wall Shear Stress Worsens Plaque Vulnerability: A Systematic Review and Meta-Analysis
title_full High Coronary Wall Shear Stress Worsens Plaque Vulnerability: A Systematic Review and Meta-Analysis
title_fullStr High Coronary Wall Shear Stress Worsens Plaque Vulnerability: A Systematic Review and Meta-Analysis
title_full_unstemmed High Coronary Wall Shear Stress Worsens Plaque Vulnerability: A Systematic Review and Meta-Analysis
title_short High Coronary Wall Shear Stress Worsens Plaque Vulnerability: A Systematic Review and Meta-Analysis
title_sort high coronary wall shear stress worsens plaque vulnerability: a systematic review and meta-analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8326896/
https://www.ncbi.nlm.nih.gov/pubmed/33535802
http://dx.doi.org/10.1177/0003319721991722
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