CLINICAL STUDY
Extensive development of vulnerable plaques as a pan-coronary process in patients with myocardial infarction: an angioscopic study
Masanori Asakura, MD*,
Yasunori Ueda, MD, PhD ,
Osamu Yamaguchi, MD*,
Takayoshi Adachi, MD ,
Atsushi Hirayama, MD, PhD,
Masatsugu Hori, MD, PhD, FACC* and
Kazuhisa Kodama, MD, PhD, FACC
* Division of Cardiology, Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine, Suita, Japan
Cardiovascular Division, Osaka Police Hospital, Osaka, Japan
Department of Cardiology, Osaka South National Hospital, Osaka, Japan
Manuscript received April 18, 2000;
revised manuscript received November 14, 2000,
accepted December 18, 2000.
Reprint requests and correspondence: Dr. Yasunori Ueda, Cardiovascular Division, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoji-ku, Osaka, 543-0035 Japan
OBJECTIVES
To test our hypothesis that the development of vulnerable plaques is not limited to the culprit lesions, but is a pan-coronary process, we directly observed all three major coronary arteries by angioscopy and evaluated the prevalence of yellow plaques in patients with myocardial infarction (MI).
BACKGROUND
Although pathologic studies have suggested that the disruption of atheromatous plaque plays a major role in the development of acute MI, the prevalence of yellow plaques in the whole coronary arteries of patients with MI has not been clarified.
METHODS
Thirty-two patients undergoing follow-up catheterization one month after the onset of MI were prospectively and consecutively enrolled in this study. The prevalence of yellow plaques and thrombus in the major coronary arteries was successfully evaluated in 20 patients (58 coronary arteries, 21 culprit lesions) by coronary angioscopy. The diameter stenosis (DS) of the culprit lesions and the maximal diameter stenosis (maxDS) of nonculprit segments were angiographically measured for each coronary artery.
RESULTS
The DS of the culprit lesions and maxDS were 27 ± 17% and 19 ± 13%, respectively. Yellow plaques and thrombus were detected in 19 (90%) and 17 (81%) of 21 culprit lesions, respectively. Yellow plaques were equally prevalent in the infarct-related and non–infarct-related coronary arteries (3.7 ± 1.6 vs. 3.4 ± 1.8 plaques/artery). However, thrombus was only detected in the nonculprit segments of one (2%) coronary artery.
CONCLUSIONS
In patients with MI, all three major coronary arteries are widely diseased and have multiple yellow though nondisrupted plaques. Acute MI may represent the pan-coronary process of vulnerable plaque development.
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Abbreviations and Acronyms
| | ACS | = acute coronary syndrome | | DS | = diameter stenosis | | HDL | = high density lipopotein | | IVUS | = intravascular ultrasound | | LAD | = left anterior descending coronary artery | | maxDS | = maximal diameter stenosis | | MI | = myocardial infarction | | RCA | = right coronary artery |
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Circ Cardiovasc Interv,
October 1, 2009;
2(5):
482 - 490.
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Hiro, T. Kimura, T. Morimoto, K. Miyauchi, Y. Nakagawa, M. Yamagishi, Y. Ozaki, K. Kimura, S. Saito, T. Yamaguchi, et al.
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J. Am. Coll. Cardiol.,
July 21, 2009;
54(4):
293 - 302.
[Abstract]
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[PDF]
|
|
|
|
|
|
|
C. M. Gardner, H. Tan, E. L. Hull, J. B. Lisauskas, S. T. Sum, T. M. Meese, C. Jiang, S. P. Madden, J. D. Caplan, A. P. Burke, et al.
Detection of lipid core coronary plaques in autopsy specimens with a novel catheter-based near-infrared spectroscopy system.
J. Am. Coll. Cardiol. Img.,
September 1, 2008;
1(5):
638 - 648.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. J. Bunch, C. S. Rihal, R. J. Gumina, L. Cooper, and N. M. Caplice
Progression of Nonculprit Plaque Stenosis Following Successful Percutaneous Intervention
Angiology,
May 1, 2008;
59(2):
236 - 239.
[Abstract]
[PDF]
|
|
|
|
|
|
|
J. A. Ambrose
In Search of the "vulnerable plaque": can it be localized and will focal regional therapy ever be an option for cardiac prevention?
J. Am. Coll. Cardiol.,
April 22, 2008;
51(16):
1539 - 1542.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Kubo, T. Imanishi, S. Takarada, A. Kuroi, S. Ueno, T. Yamano, T. Tanimoto, Y. Matsuo, T. Masho, H. Kitabata, et al.
Assessment of Culprit Lesion Morphology in Acute Myocardial Infarction: Ability of Optical Coherence Tomography Compared With Intravascular Ultrasound and Coronary Angioscopy
J. Am. Coll. Cardiol.,
September 4, 2007;
50(10):
933 - 939.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. W. Serruys, H. M. Garcia-Garcia, and E. Regar
From Postmortem Characterization to the In Vivo Detection of Thin-Capped Fibroatheromas: The Missing Link Toward Percutaneous Treatment: What If Diogenes Would Have Found What He Was Looking For?
J. Am. Coll. Cardiol.,
September 4, 2007;
50(10):
950 - 952.
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. K. Cheruvu, A. V. Finn, C. Gardner, J. Caplan, J. Goldstein, G. W. Stone, R. Virmani, and J. E. Muller
Frequency and Distribution of Thin-Cap Fibroatheroma and Ruptured Plaques in Human Coronary Arteries: A Pathologic Study
J. Am. Coll. Cardiol.,
September 4, 2007;
50(10):
940 - 949.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
O. C. Raffel, G. J. Tearney, D. D. Gauthier, E. F. Halpern, B. E. Bouma, and I.-K. Jang
Relationship Between a Systemic Inflammatory Marker, Plaque Inflammation, and Plaque Characteristics Determined by Intravascular Optical Coherence Tomography
Arterioscler Thromb Vasc Biol,
August 1, 2007;
27(8):
1820 - 1827.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Saam, T. S. Hatsukami, N. Takaya, B. Chu, H. Underhill, W. S. Kerwin, J. Cai, M. S. Ferguson, and C. Yuan
The Vulnerable, or High-Risk, Atherosclerotic Plaque: Noninvasive MR Imaging for Characterization and Assessment
Radiology,
July 1, 2007;
244(1):
64 - 77.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Amano, T. Matsubara, T. Uetani, M. Nanki, N. Marui, M. Kato, K. Arai, K. Yokoi, H. Ando, H. Ishii, et al.
Impact of Metabolic Syndrome on Tissue Characteristics of Angiographically Mild to Moderate Coronary Lesions: Integrated Backscatter Intravascular Ultrasound Study
J. Am. Coll. Cardiol.,
March 20, 2007;
49(11):
1149 - 1156.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Waxman, F. Ishibashi, and J. E. Muller
Detection and Treatment of Vulnerable Plaques and Vulnerable Patients: Novel Approaches to Prevention of Coronary Events
Circulation,
November 28, 2006;
114(22):
2390 - 2411.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. A. Elesber, C. A. Conover, A. E. Denktas, R. J. Lennon, D. R. Holmes Jr, M. T. Overgaard, M. Christiansen, C. Oxvig, L. O. Lerman, and A. Lerman
Prognostic value of circulating pregnancy-associated plasma protein levels in patients with chronic stable angina
Eur. Heart J.,
July 2, 2006;
27(14):
1678 - 1684.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Ohtani, Y. Ueda, I. Mizote, J. Oyabu, K. Okada, A. Hirayama, and K. Kodama
Number of Yellow Plaques Detected in a Coronary Artery Is Associated With Future Risk of Acute Coronary Syndrome: Detection of Vulnerable Patients by Angioscopy
J. Am. Coll. Cardiol.,
June 6, 2006;
47(11):
2194 - 2200.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. W. Stone and H. D. Aronow
Long-term Care After Percutaneous Coronary Intervention: Focus on the Role of Antiplatelet Therapy
Mayo Clin. Proc.,
May 1, 2006;
81(5):
641 - 652.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. N. DeMaria, J. Narula, E. Mahmud, and S. Tsimikas
Imaging vulnerable plaque by ultrasound.
J. Am. Coll. Cardiol.,
April 18, 2006;
47(8 Suppl):
C32 - C39.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. W. Strauss, C. Mari, B. E. Patt, and V. Ghazarossian
Intravascular radiation detectors for the detection of vulnerable atheroma.
J. Am. Coll. Cardiol.,
April 18, 2006;
47(8 Suppl):
C97 - C100.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Sakakura, T. Yasu, Y. Kobayashi, T. Katayama, Y. Sugawara, H. Funayama, Y. Takagi, N. Ikeda, T. Ishida, Y. Tsuruya, et al.
Noninvasive Tissue Characterization of Coronary Arterial Plaque by 16-Slice Computed Tomography in Acute Coronary Syndrome
Angiology,
March 1, 2006;
57(2):
155 - 160.
[Abstract]
[PDF]
|
|
|
|
|
|
|
K. Sano, M. Kawasaki, Y. Ishihara, M. Okubo, K. Tsuchiya, K. Nishigaki, X. Zhou, S. Minatoguchi, H. Fujita, and H. Fujiwara
Assessment of Vulnerable Plaques Causing Acute Coronary Syndrome Using Integrated Backscatter Intravascular Ultrasound
J. Am. Coll. Cardiol.,
February 21, 2006;
47(4):
734 - 741.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Escolar, G. Weigold, A. Fuisz, and N. J. Weissman
New imaging techniques for diagnosing coronary artery disease.
Can. Med. Assoc. J.,
February 14, 2006;
174(4):
487 - 495.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Toutouzas, M. Drakopoulou, J. Mitropoulos, E. Tsiamis, S. Vaina, M. Vavuranakis, V. Markou, E. Bosinakou, and C. Stefanadis
Elevated Plaque Temperature in Non-Culprit De Novo Atheromatous Lesions of Patients With Acute Coronary Syndromes
J. Am. Coll. Cardiol.,
January 17, 2006;
47(2):
301 - 306.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. A. Rodriguez-Granillo, H. M. Garcia-Garcia, E. P. Mc Fadden, M. Valgimigli, J. Aoki, P. de Feyter, and P. W. Serruys
In Vivo Intravascular Ultrasound-Derived Thin-Cap Fibroatheroma Detection Using Ultrasound Radiofrequency Data Analysis
J. Am. Coll. Cardiol.,
December 6, 2005;
46(11):
2038 - 2042.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E J Smith, A Mathur, and M T Rothman
Recent advances in primary percutaneous intervention for acute myocardial infarction
Heart,
December 1, 2005;
91(12):
1533 - 1536.
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Libby and P. Theroux
Pathophysiology of Coronary Artery Disease
Circulation,
June 28, 2005;
111(25):
3481 - 3488.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Tanaka, K. Shimada, T. Sano, M. Namba, T. Sakamoto, Y. Nishida, T. Kawarabayashi, D. Fukuda, and J. Yoshikawa
Multiple Plaque Rupture and C-Reactive Protein in Acute Myocardial Infarction
J. Am. Coll. Cardiol.,
May 17, 2005;
45(10):
1594 - 1599.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. A. Ambrose and D. J. D'Agate
Plaque rupture and intracoronary thrombus in nonculprit vessels: An eyewitness account
J. Am. Coll. Cardiol.,
March 1, 2005;
45(5):
659 - 660.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Madjid, A. Zarrabi, S. Litovsky, J. T. Willerson, and W. Casscells
Finding Vulnerable Atherosclerotic Plaques: Is It Worth the Effort?
Arterioscler Thromb Vasc Biol,
October 1, 2004;
24(10):
1775 - 1782.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Zouridakis, P. Avanzas, R. Arroyo-Espliguero, S. Fredericks, and J. C. Kaski
Markers of Inflammation and Rapid Coronary Artery Disease Progression in Patients With Stable Angina Pectoris
Circulation,
September 28, 2004;
110(13):
1747 - 1753.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. D. MacNeill, I.-K. Jang, B. E. Bouma, N. Iftimia, M. Takano, H. Yabushita, M. Shishkov, C. R. Kauffman, S. L. Houser, H.T. Aretz, et al.
Focal and multi-focal plaque macrophage distributions in patients with acute and stable presentations of coronary artery disease
J. Am. Coll. Cardiol.,
September 1, 2004;
44(5):
972 - 979.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M.-K. Hong, G. S. Mintz, C. W. Lee, Y.-H. Kim, S.-W. Lee, J.-M. Song, K.-H. Han, D.-H. Kang, J.-K. Song, J.-J. Kim, et al.
Comparison of Coronary Plaque Rupture Between Stable Angina and Acute Myocardial Infarction: A Three-Vessel Intravascular Ultrasound Study in 235 Patients
Circulation,
August 24, 2004;
110(8):
928 - 933.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P Avanzas, R Arroyo-Espliguero, J Cosin-Sales, G Aldama, C Pizzi, J Quiles, and J C Kaski
Markers of inflammation and multiple complex stenoses (pancoronary plaque vulnerability) in patients with non-ST segment elevation acute coronary syndromes
Heart,
August 1, 2004;
90(8):
847 - 852.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. C. Wang, S.-L. T. Normand, L. Mauri, and R. E. Kuntz
Coronary Artery Spatial Distribution of Acute Myocardial Infarction Occlusions
Circulation,
July 20, 2004;
110(3):
278 - 284.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. W. Strauss, M. Dunphy, and N. Tokita
Imaging the Vulnerable Plaque: A Scintillating Light at the End of the Tunnel?
J. Nucl. Med.,
July 1, 2004;
45(7):
1106 - 1107.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D.D. Waters and K.K. Khush
Management of the acute coronary syndrome patient
Eur. Heart J. Suppl.,
July 1, 2004;
6(suppl_C):
C49 - C57.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. G. Neri Serneri, M. Boddi, P. A. Modesti, M. Coppo, I. Cecioni, T. Toscano, M. L. Papa, M. Bandinelli, G. F. Lisi, and M. Chiavarelli
Cardiac Angiotensin II Participates in Coronary Microvessel Inflammation of Unstable Angina and Strengthens the Immunomediated Component
Circ. Res.,
June 25, 2004;
94(12):
1630 - 1637.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. A. Schaar, E. Regar, F. Mastik, E. P. McFadden, F. Saia, C. Disco, C. L. de Korte, P. J. de Feyter, A. F.W. van der Steen, and P. W. Serruys
Incidence of High-Strain Patterns in Human Coronary Arteries: Assessment With Three-Dimensional Intravascular Palpography and Correlation With Clinical Presentation
Circulation,
June 8, 2004;
109(22):
2716 - 2719.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. A Schaar, J. E Muller, E. Falk, R. Virmani, V. Fuster, P. W Serruys, A. Colombo, C. Stefanadis, S Ward Casscells, P. R Moreno, et al.
Terminology for high-risk and vulnerable coronary artery plaques
Eur. Heart J.,
June 2, 2004;
25(12):
1077 - 1082.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. P. Cannon, E. Braunwald, C. H. McCabe, D. J. Rader, J. L. Rouleau, R. Belder, S. V. Joyal, K. A. Hill, M. A. Pfeffer, A. M. Skene, et al.
Intensive versus Moderate Lipid Lowering with Statins after Acute Coronary Syndromes
N. Engl. J. Med.,
April 8, 2004;
350(15):
1495 - 1504.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. W. Leber, A. Knez, A. Becker, C. Becker, F. von Ziegler, K. Nikolaou, C. Rist, M. Reiser, C. White, G. Steinbeck, et al.
Accuracy of multidetector spiral computed tomography in identifying and differentiating the composition of coronary atherosclerotic plaques: A comparative study with intracoronary ultrasound
J. Am. Coll. Cardiol.,
April 7, 2004;
43(7):
1241 - 1247.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Arroyo-Espliguero, P. Avanzas, J. Cosin-Sales, G. Aldama, C. Pizzi, and J. C. Kaski
C-reactive protein elevation and disease activity in patients with coronary artery disease
Eur. Heart J.,
March 1, 2004;
25(5):
401 - 408.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. S. Forrester
Toward understanding the evolution of plaque rupture: Correlating vascular pathology with clinical outcomes
J. Am. Coll. Cardiol.,
November 5, 2003;
42(9):
1566 - 1568.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Naghavi, P. Libby, E. Falk, S. W. Casscells, S. Litovsky, J. Rumberger, J. J. Badimon, C. Stefanadis, P. Moreno, G. Pasterkamp, et al.
From Vulnerable Plaque to Vulnerable Patient: A Call for New Definitions and Risk Assessment Strategies: Part I
Circulation,
October 7, 2003;
108(14):
1664 - 1672.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Schoenhagen, G. W. Stone, S. E. Nissen, C. L. Grines, J. Griffin, B. S. Clemson, D. G. Vince, K. Ziada, T. Crowe, C. Apperson-Hanson, et al.
Coronary Plaque Morphology and Frequency of Ulceration Distant From Culprit Lesions in Patients With Unstable and Stable Presentation
Arterioscler Thromb Vasc Biol,
October 1, 2003;
23(10):
1895 - 1900.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. M. Tuzcu and P. Schoenhagen
Acute coronary syndromes, plaque vulnerability,and carotid artery disease: The changing role ofatherosclerosis imaging
J. Am. Coll. Cardiol.,
September 17, 2003;
42(6):
1033 - 1036.
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. D. MacNeill, H. C. Lowe, M. Takano, V. Fuster, and I.-K. Jang
Intravascular Modalities for Detection of Vulnerable Plaque: Current Status
Arterioscler Thromb Vasc Biol,
August 1, 2003;
23(8):
1333 - 1342.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. G. Neri Serneri, M. Boddi, P. A. Modesti, I. Cecioni, M. Coppo, M. L. Papa, T. Toscano, A. Marullo, and M. Chiavarelli
Immunomediated and Ischemia-Independent Inflammation of Coronary Microvessels in Unstable Angina
Circ. Res.,
June 27, 2003;
92(12):
1359 - 1366.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J.-i. Kotani, G. S. Mintz, M. T. Castagna, E. Pinnow, C. O. Berzingi, A. B. Bui, A. D. Pichard, L. F. Satler, W. O. Suddath, R. Waksman, et al.
Intravascular Ultrasound Analysis of Infarct-Related and Non-Infarct-Related Arteries in Patients Who Presented With an Acute Myocardial Infarction
Circulation,
June 17, 2003;
107(23):
2889 - 2893.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. Casscells, M. Naghavi, and J. T. Willerson
Vulnerable Atherosclerotic Plaque: A Multifocal Disease
Circulation,
April 29, 2003;
107(16):
2072 - 2075.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. G. McKay
"Ischemia-guided" versus "early invasive" strategies in the management of acute coronary syndrome/non-ST-segment elevation myocardial infarction: The interventionalist's perspective
J. Am. Coll. Cardiol.,
February 19, 2003;
41(4_Suppl_S):
96S - 102S.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. E. Nissen
Pathobiology, not angiography, should guide managementin acute coronary syndrome/non-ST-segment elevation myocardial infarction: The non-interventionist's perspective
J. Am. Coll. Cardiol.,
February 19, 2003;
41(4_Suppl_S):
103S - 112S.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Valgimigli, L. Agnoletti, S. Curello, L. Comini, G. Francolini, F. Mastrorilli, E. Merli, R. Pirani, G. Guardigli, P. G. Grigolato, et al.
Serum From Patients With Acute Coronary Syndromes Displays a Proapoptotic Effect on Human Endothelial Cells: A Possible Link to Pan-Coronary Syndromes
Circulation,
January 21, 2003;
107(2):
264 - 270.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. C. Sposito and M. J. Chapman
Statin Therapy in Acute Coronary Syndromes: Mechanistic Insight Into Clinical Benefit
Arterioscler Thromb Vasc Biol,
October 1, 2002;
22(10):
1524 - 1534.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Maehara, G. S. Mintz, A. B. Bui, O. R. Walter, M. T. Castagna, D. Canos, A. D. Pichard, L. F. Satler, R. Waksman, W. O. Suddath, et al.
Morphologic and angiographic features of coronary plaque rupture detected by intravascular ultrasound
J. Am. Coll. Cardiol.,
September 4, 2002;
40(5):
904 - 910.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. G. Hanratty, Y. Koyama, H. H. Rasmussen, G. I. C. Nelson, P. S. Hansen, and M. R. Ward
Exaggeration of nonculprit stenosis severity during acute myocardial infarction: implications for immediate multivessel revascularization
J. Am. Coll. Cardiol.,
September 4, 2002;
40(5):
911 - 916.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Schoenhagen, E. M. Tuzcu, and S. G. Ellis
Plaque Vulnerability, Plaque Rupture, and Acute Coronary Syndromes: (Multi)-Focal Manifestation of a Systemic Disease Process
Circulation,
August 13, 2002;
106(7):
760 - 762.
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Rioufol, G. Finet, I. Ginon, X. Andre-Fouet, R. Rossi, E. Vialle, E. Desjoyaux, G. Convert, J.F. Huret, and A. Tabib
Multiple Atherosclerotic Plaque Rupture in Acute Coronary Syndrome: A Three-Vessel Intravascular Ultrasound Study
Circulation,
August 13, 2002;
106(7):
804 - 808.
[Abstract]
[Full Text]
[PDF]
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J. A. Goldstein
Angiographic plaque complexity: the tip of the unstable plaque iceberg
J. Am. Coll. Cardiol.,
May 1, 2002;
39(9):
1464 - 1467.
[Full Text]
[PDF]
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