Plaque Composition in the Left Main Stem Mimics the Distal But Not the Proximal Tract of the Left Coronary Artery
Influence of Clinical Presentation, Length of the Left Main Trunk, Lipid Profile, and Systemic Levels of C-Reactive Protein
Marco Valgimigli, MD, PhD,
Gastón A. Rodriguez-Granillo, MD, PhD1,
Héctor M. Garcia-Garcia, MD,
Sophia Vaina, MD, PhD,
Peter De Jaegere, MD, PhD,
Pim De Feyter, MD, PhD and
Patrick W. Serruys, MD, PhD*
Erasmus Medical Center, Thoraxcenter, Rotterdam, the Netherlands.
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Figure 1 Change in Plaque Composition Along the Left Coronary Artery
Plaque composition in terms of median necrotic, fibrolipid, fibrous, and calcium core content along the left coronary vessel (A). In panel B, the percentage of each plaque component is reported with respect to left main coronary artery (LMCA) taken as reference. All analyses are based on model 1.
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Figure 2 Plaque Composition in Relation to Clinical Presentation
Plaque composition on a per-segment based analysis in patients with stable angina (stable patients) or with acute coronary syndromes (unstable patients). The necrotic core (%) was significantly increased in patients with (median [interquartile range] 11.4 [5.5 to 19.8]) as compared to those without (7.3 [3.2 to 12.9]) an acute coronary syndrome. *p < 0.001 versus stable patients.
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Figure 3 Necrotic Core Distribution Along the Left Coronary Artery According to the Length of LMS
The necrotic core peaked in the first and in the second 6-mm segment in patients with long (above median value) and short left main coronary artery (LMS), respectively. After the peak, the necrotic core decrease was more pronounced in the long than in the short LMS group. As a consequence, the necrotic core content resulted to be significantly increased in the fifth and sixth 6-mm segments in the short as compared with the long LMS group. *p < 0.05 versus short LMS.
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Figure 4 Correlation Between Necrotic Core and Plaque Size
No correlation was found between arcsin-transformed necrotic core content and plaque size evaluated through log-transformed plaque cross-sectional area (CSA). Arcsin is the inverse of sine and is the inverse trigonometric function.
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