HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (19) Citing Articles via Google Scholar Google Scholar Articles by Takano, M. Articles by Mizuno, K. Search for Related Content PubMed PubMed Citation Articles by Takano, M. Articles by Mizuno, K. Related Collections Related Article

CLINICAL RESEARCH: CORONARY ARTERY DISEASE

Angioscopic follow-up study of coronary ruptured plaques in nonculprit lesions

Department of Internal Medicine, Chiba-Hokusoh Hospital, Nippon Medical School, Chiba, Japan

Manuscript received June 3, 2004; revised manuscript received September 8, 2004, accepted September 13, 2004.

^* Reprint requests and correspondence: Dr. Kyoichi Mizuno, Department of Internal Medicine, Chiba-Hokusoh Hospital, Nippon Medical School, 1715 Kamakari, Imba, Chiba, Japan 270-1694 (Email: mizunok{at}nms.ac.jp).

OBJECTIVES: Changes of ruptured plaques in nonculprit lesions were evaluated using coronary angioscopy.

BACKGROUND: The concept of multiple coronary plaque ruptures has been established. However, no detailed follow-up studies of ruptured plaques in nonculprit lesions have yet been reported.

METHODS: Forty-eight thrombi in 50 ruptured coronary plaques in nonculprit lesions in 30 patients were identified by angioscopy. The percent diameter stenosis (%DS) at the target plaques on quantitative coronary angiographic analysis and the serum C-reactive protein (CRP) level were measured.

RESULTS: The mean angioscopic follow-up period was 13 ± 9 months. Thirty-five superimposed thrombi still remained at follow-up, and the predominant thrombus color changed from red (56%) at baseline to pinkish-white (83%) at follow-up. The healing rate increased according to the angioscopic follow-up period (23% at 12 months vs. 55% at >12 months, p = 0.044). The %DS at the healed plaque increased from baseline to follow-up (12.3 ± 5.8% vs. 22.7 ± 11.6%, respectively; p = 0.0004). The serum CRP level in patients with healed plaques (n = 10) was lower than that in those without healed plaques (n = 19; 0.07 ± 0.03 mg/dl vs. 0.15 ± 0.11 mg/dl, respectively; p = 0.007).

CONCLUSIONS: The present study demonstrated that: 1) ruptured plaques in nonculprit lesions tend to heal slowly with a progression of angiographic stenosis; and 2) the serum CRP level might reflect the disease activity of the plaque ruptures.

Abbreviations and Acronyms   ACS = acute coronary syndrome   CRP = C-reactive protein   %DS = percent diameter stenosis   IVUS = intravascular ultrasound   LAD = left anterior descending coronary artery   LCx = left circumflex artery   MI = myocardial infarction   PCI = percutaneous coronary intervention   QCA = quantitative coronary angiogram   RCA = right coronary artery   SAP = stable angina pectoris   UAP = unstable angina pectoris

Related Article

Plaque rupture and intracoronary thrombus in nonculprit vessels: An eyewitness account

John A. Ambrose and David J. D’Agate
J. Am. Coll. Cardiol. 2005 45: 659-660. [Full Text] [PDF]

This article has been cited by other articles:

				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]

				C. L. Jackson, M. R. Bennett, E. A.L. Biessen, J. L. Johnson, and R. Krams Assessment of Unstable Atherosclerosis in Mice Arterioscler. Thromb. Vasc. Biol., April 1, 2007; 27(4): 714 - 720. [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]

				G. H. Tofler and J. E. Muller Triggering of Acute Cardiovascular Disease and Potential Preventive Strategies Circulation, October 24, 2006; 114(17): 1863 - 1872. [Full Text] [PDF]

				M. Takano, T. Ohba, S. Inami, K. Seimiya, S. Sakai, and K. Mizuno Angioscopic differences in neointimal coverage and in persistence of thrombus between sirolimus-eluting stents and bare metal stents after a 6-month implantation Eur. Heart J., September 2, 2006; 27(18): 2189 - 2195. [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]