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J Am Coll Cardiol, 2006; 47:2194-2200, doi:10.1016/j.jacc.2006.01.064 (Published online 12 May 2006).
© 2006 by the American College of Cardiology Foundation
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Number of Yellow Plaques Detected in a Coronary Artery Is Associated With Future Risk of Acute Coronary Syndrome

Detection of Vulnerable Patients by Angioscopy

Tomohito Ohtani, MD1, Yasunori Ueda, MD, PhD, FACC, FESC1,*, Isamu Mizote, MD, Jota Oyabu, MD, Katsuki Okada, MD, Atsushi Hirayama, MD, PhD, FACC and Kazuhisa Kodama, MD, PhD, FACC

Cardiovascular Division, Osaka Police Hospital, Osaka, Japan.


Figure 1
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  		Figure 1 Distributions of number of yellow plaques (NYP) (A) and maximum color grade of yellow plaques (maxYP) (B). Patients with NYP ≥2 and those with NYP ≥5 comprised 60% and 9% of study patients, respectively.

 

Figure 2
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  		Figure 2 A representative case with no yellow plaque (A) and a representative case with multiple yellow plaques (B). (A) No yellow plaque was detected in the right coronary artery: number of yellow plaques (NYP) 0, maximum color grade of yellow plaques (maxYP) 0. (B) Three yellow plaques were detected in the right coronary artery: NYP 3, maxYP 3.

 

Figure 3
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  		Figure 3 A case in which culprit vessel of acute coronary syndrome event had been observed by angioscopy at baseline. The patient was a 48-year-old man. (A) Initial clinical presentation when angioscopy was performed was inferior acute myocardial infarction. The culprit lesion was in the distal right coronary artery. (B) The second event was also inferior acute myocardial infarction, 51 months later. The culprit lesion was in the proximal right coronary artery where yellow plaque had been detected. PCI = percutaneous coronary intervention.

 

Figure 4
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  		Figure 4 Incidence of acute coronary syndrome (ACS) events. The incidence of ACS events was estimated with the Kaplan-Meier method. Patients with multiple yellow plaques (number of yellow plaques [NYP] ≥2) had a significantly higher incidence (p = 0.02 by log rank test) of ACS events compared with those with fewer yellow plaques (NYP 0 or 1).

 




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