According to post-mortem studies, luminal thrombosis occurs from plaque rupture, erosion and calcified nodules. In vivo studies have found thin cap fibroatheroma (TCFA) as the main vulnerable lesion, prone to rupture. Few data about other post-mortem lesions have been reported in vivo. Our main objective is to characterize in vivo the coronary plaques with intravascular ultrasound-virtual histology (IVUS-VH) and optical coherence tomography (OCT), in order to detect not only thin cap fibroatheroma (TCFA), but also other possible vulnerable lesions. The secondary objective is to correlate these findings with clinical and analytical data. Twenty-five patients (18 stable) submitted to coronary angiography were included in this pilot study. After angiography, the three vessels were studied (when possible) with IVUS-VH and OCT. Plaque characteristics were correlated with clinical and analytical data. Forty-six lesions were analyzed. IVUS-VH detected significant necrotic core in 15 (3 were definite TCFA). OCT detected TCFA in 10 lesions, erosion in 6, thrombus in 5 and calcified nodule in 8. Possible vulnerable lesion was found in 61% of stable and 57% of unstable patients. Erosions and calcified nodules were only found in stable patients. Those with significant necrotic core had higher body mass index (P=0.016), higher levels of hs-CRP (P=0.019) and triglycerides (P=0.040). The higher the levels of hs-CRP, the larger the size of the necrotic core (r=0.69, P=0.003). Lesions with characteristics of vulnerability were detected by IVUS-VH and OCT in more than 50% of stable and unstable coronary patients. A significant necrotic core was mainly correlated with higher hs-CRP.
Vulnerable plaque, thin cap fibro – atheroma, necrotic core.
José Calabuig, Dept. Cardiology, Clínica Universidad de Navarra, Avda Pio Doce 36, 31008 Pamplona, Spain. E-mail: firstname.lastname@example.org
We gratefully acknowledge the
help of the Cath Lab nurses. Thanks to their
unconditional support we have been able to carry
out this research.
This work was partially supported by a grant from:
Departamento de Salud. Gobierno de Navarra
(ref 15/2008) and PIUNA, Universidad de
Share this Article
Related Content In Imaging
The Evolving Role of Echocardiography During the Coronavirus Disease 2019 Pandemic
Heart International. 2022;16(1):28–36 DOI: https://doi.org/10.17925/HI.2022.16.1.28
As of the publication of this article, the coronavirus disease 2019 (COVID-19) infection has affected over 400 million people around the world and caused over 6 million deaths.1 Although COVID-19 infection predominantly affects the respiratory system, studies have described a wide spectrum of cardiovascular manifestations, including asymptomatic myocardial injury, myocardial infarction and myocarditis.2 Echocardiography is an easily […]
The Quantification of Total Coronary Atheroma Burden – A Major Step Forward
Heart International. 2020;14(2):73-5 DOI: https://doi.org/10.17925/HI.2020.14.2.73
More than half of acute coronary syndromes (ACS) occur in subjects with no significant coronary stenosis.1 In view of the number of patients dying each year from a heart attack, the question of identifying these patients is of primary importance. A large body of evidence currently exists, indicating that total coronary atheroma burden (TOCAB) – the […]
Left main Stenosis Stenting Normalizes Wall Shear Stress of Ascending Aorta in Bicuspid Aortic Valve
Heart International. 2020;14(2):121-2 DOI: https://doi.org/10.17925/HI.2020.14.2.121
Bicuspid aortic valve (BAV) represents the most common congenital cardiac anomaly, with a prevalence ranging between 1% and 2% in the general population.1 BAV is known to be associated with dilation and dissection of the ascending aorta, and the significantly higher shear forces seem to have a pivotal role on the development of such complications.2 Nowadays, patients […]
Journal articles and more to your inbox
Get the latest clinical insights from touchCARDIOSign me up!