|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
|
|
|
|||||||||
|
|||||||||||
|
J Am Coll Cardiol, 2002; 40:904-910 © 2002 by the American College of Cardiology Foundation |
* Cardiovascular Research Institute, Washington Hospital Center, Washington, DC, USA
Cardiovascular Research Foundation, New York, New York, USA
Manuscript received December 19, 2001; revised manuscript received May 2, 2002, accepted May 24, 2002.
* Reprint requests and correspondence: Dr. Neil J. Weissman, Cardiovascular Research Institute, 110 Irving St, NW Suite 4B-1, Washington, DC 20010, USA
Neil.J.Weissman{at}medstar.net
OBJECTIVES: This study was designed to report the clinical and angiographic correlates of plaque rupture detected by intravascular ultrasound (IVUS).
BACKGROUND: Acute coronary syndromes result from spontaneous plaque rupture and thrombosis.
METHODS: We report 300 plaque ruptures in 257 arteries in 254 patients. Plaque ruptures were detected during pre-intervention IVUS. Standard clinical, angiographic, and IVUS parameters were collected and/or measured. One lesion per patient was analyzed.
RESULTS: Multiple ruptures were observed in 39 of 254 patients (15%), 36 in the same artery. Plaque rupture occurred not only in patients with unstable angina (46%) or myocardial infarction (MI, 33%), but also stable angina (11%) or no symptoms (11%). The tear in the fibrous cap could be identified in 157 of 254 patients; 63% occurred at the shoulder of the plaque and 37% in the center of the plaque. Thrombi were more common in patients with unstable angina or MI (p = 0.02) and in multiple ruptures (p = 0.04). The plaque rupture site contained the minimum lumen area (MLA) site in only 28% of patients; rupture sites had larger arterial and lumen areas and more positive remodeling than MLA sites. Intravascular ultrasound plaque rupture strongly correlated with complex angiographic lesion morphology: ulceration in 81%, intimal flap in 40%, thrombus in 7%, and aneurysm in 7%.
CONCLUSIONS: Plaque ruptures occur with varying clinical presentations, strongly correlate with angiographic complex lesion morphology, may be multiple, and usually do not cause lumen compromise.
| ||||||||||||||||
This article has been cited by other articles:
|
|
 |
|
  Y. J. Hong, M. H. Jeong, Y. Ahn, D. S. Sim, J. W. Chung, J. S. Cho, N. S. Yoon, H. J. Yoon, J. Y. Moon, K. H. Kim, et al. Plaque Prolapse After Stent Implantation in Patients With Acute Myocardial Infarction: An Intravascular Ultrasound Analysis J. Am. Coll. Cardiol. Img., July 1, 2008; 1(4): 489 - 497. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Foglieni, F. Maisano, L. Dreas, A. Giazzon, G. Ruotolo, E. Ferrero, L. Li Volsi, S. Coli, G. Sinagra, B. Zingone, et al. Mild inflammatory activation of mammary arteries in patients with acute coronary syndromes Am J Physiol Heart Circ Physiol, June 1, 2008; 294(6): H2831 - H2837. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Takumi, S. Lee, S. Hamasaki, K. Toyonaga, D. Kanda, K. Kusumoto, H. Toda, T. Takenaka, M. Miyata, R. Anan, et al. Limitation of Angiography to Identify the Culprit Plaque in Acute Myocardial Infarction With Coronary Total Occlusion: Utility of Coronary Plaque Temperature Measurement to Identify the Culprit Plaque J. Am. Coll. Cardiol., December 4, 2007; 50(23): 2197 - 2203. [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]
|
|
|
|
|
|
S. Motoyama, T. Kondo, M. Sarai, A. Sugiura, H. Harigaya, T. Sato, K. Inoue, M. Okumura, J. Ishii, H. Anno, et al. Multislice Computed Tomographic Characteristics of Coronary Lesions in Acute Coronary Syndromes J. Am. Coll. Cardiol., July 24, 2007; 50(4): 319 - 326. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Toutouzas, A. Synetos, E. Stefanadi, S. Vaina, V. Markou, M. Vavuranakis, E. Tsiamis, D. Tousoulis, and C. Stefanadis Correlation Between Morphologic Characteristics and Local Temperature Differences in Culprit Lesions of Patients With Symptomatic Coronary Artery Disease J. Am. Coll. Cardiol., June 12, 2007; 49(23): 2264 - 2271. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Lerman, D. R. Holmes, J. Herrmann, and B. J. Gersh Microcirculatory dysfunction in ST-elevation myocardial infarction: cause, consequence, or both? Eur. Heart J., April 1, 2007; 28(7): 788 - 797. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Vengrenyuk, S. Carlier, S. Xanthos, L. Cardoso, P. Ganatos, R. Virmani, S. Einav, L. Gilchrist, and S. Weinbaum A hypothesis for vulnerable plaque rupture due to stress-induced debonding around cellular microcalcifications in thin fibrous caps PNAS, October 3, 2006; 103(40): 14678 - 14683. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. A. Rodriguez-Granillo, H. M. Garcia-Garcia, M. Valgimigli, S. Vaina, C. van Mieghem, R. J. van Geuns, M. van der Ent, E. Regar, P. de Jaegere, W. van der Giessen, et al. Global characterization of coronary plaque rupture phenotype using three-vessel intravascular ultrasound radiofrequency data analysis Eur. Heart J., August 2, 2006; 27(16): 1921 - 1927. [Abstract] [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]
|
|
|
|
 |
|
 U. Hoffmann, A. J. Pena, R. C. Cury, S. Abbara, M. Ferencik, F. Moselewski, U. Siebert, T. J. Brady, and J. T. Nagurney Cardiac CT in Emergency Department Patients with Acute Chest Pain. RadioGraphics, July 1, 2006; 26(4): 963 - 978. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U. Hoffmann, F. Moselewski, K. Nieman, I.-K. Jang, M. Ferencik, A. M. Rahman, R. C. Cury, S. Abbara, H. Joneidi-Jafari, S. Achenbach, et al. Noninvasive Assessment of Plaque Morphology and Composition in Culprit and Stable Lesions in Acute Coronary Syndrome and Stable Lesions in Stable Angina by Multidetector Computed Tomography J. Am. Coll. Cardiol., April 18, 2006; 47(8): 1655 - 1662. [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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
A. W. Leber, A. Becker, A. Knez, F. von Ziegler, M. Sirol, K. Nikolaou, B. Ohnesorge, Z. A. Fayad, C. R. Becker, M. Reiser, et al. Accuracy of 64-Slice Computed Tomography to Classify and Quantify Plaque Volumes in the Proximal Coronary System: A Comparative Study Using Intravascular Ultrasound J. Am. Coll. Cardiol., February 7, 2006; 47(3): 672 - 677. [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]
|
|
|
|
|
|
J. Narula, A. V. Finn, and A. N. DeMaria Picking Plaques That Pop ... J. Am. Coll. Cardiol., June 21, 2005; 45(12): 1970 - 1973. [Full Text] [PDF]
|
|
|
|
|
|
J. Pregowski, P. Tyczynski, G. S. Mintz, S.-W. Kim, A. Witkowski, R. Waksman, A. Pichard, L. Satler, K. Kent, M. Kruk, et al. Incidence and Clinical Correlates of Ruptured Plaques in Saphenous Vein Grafts: An Intravascular Ultrasound Study J. Am. Coll. Cardiol., June 21, 2005; 45(12): 1974 - 1979. [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.-i. Kotani, G. S. Mintz, P. B. Rai, C. K. Pappas, N. Gevorkian, A. B. Bui, A. D. Pichard, L. F. Satler, W. O. Suddath, R. Waksman, et al. Intravascular ultrasound assessment of angiographic filling defects in native coronary arteries: Do they always contain thrombi? J. Am. Coll. Cardiol., November 16, 2004; 44(10): 2087 - 2089. [Full Text] [PDF]
|
|
|
|
 |
|
 G. Rioufol, M. Gilard, G. Finet, I. Ginon, J. Boschat, and X. Andre-Fouet Evolution of Spontaneous Atherosclerotic Plaque Rupture With Medical Therapy: Long-Term Follow-Up With Intravascular Ultrasound Circulation, November 2, 2004; 110(18): 2875 - 2880. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.K. Lovett, P.J. Gallagher, L.J. Hands, J. Walton, and P.M. Rothwell Histological Correlates of Carotid Plaque Surface Morphology on Lumen Contrast Imaging Circulation, October 12, 2004; 110(15): 2190 - 2197. [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. Cosin-Sales, M. Christiansen, P. Kaminski, C. Oxvig, M. T. Overgaard, D. Cole, D. W. Holt, and J. C. Kaski Pregnancy-Associated Plasma Protein A and Its Endogenous Inhibitor, the Proform of Eosinophil Major Basic Protein (proMBP), Are Related to Complex Stenosis Morphology in Patients With Stable Angina Pectoris Circulation, April 13, 2004; 109(14): 1724 - 1728. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Fujii, Y. Kobayashi, G. S. Mintz, H. Takebayashi, G. Dangas, I. Moussa, R. Mehran, A. J. Lansky, E. Kreps, M. Collins, et al. Intravascular Ultrasound Assessment of Ulcerated Ruptured Plaques: A Comparison of Culprit and Nonculprit Lesions of Patients With Acute Coronary Syndromes and Lesions in Patients Without Acute Coronary Syndromes Circulation, November 18, 2003; 108(20): 2473 - 2478. [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]
|
|
|
|
|
|
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]
|
|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
