- Email: [email protected]
WHICH VIRTUAL HISTOLOGY INTRAVASCULAR ULTRASOUND PROPERTIES DISCRIMINATE BETTER BETWEEN STABLE ANGINA PECTORIS AND TROPONIN POSITIVE ACUTE CORONARY SYNDROME - ASSESSMENT OF PLAQUES OR ANALYSIS OF THE WHOLE CORONARY ARTERY VASCULATURE?
A189.E1767 JACC March 9, 2010 Volume 55, issue 10A
i2 SUMMIT WHICH VIRTUAL HISTOLOGY INTRAVASCULAR ULTRASOUND PROPERTIES DISCRIMINATE BETTER BETWEEN STABLE ANGINA PECTORIS AND TROPONIN POSITIVE ACUTE CORONARY SYNDROME ASSESSMENT OF PLAQUES OR ANALYSIS OF THE WHOLE CORONARY ARTERY VASCULATURE? i2 Poster Contributions Georgia World Congress Center, Hall B5 Sunday, March 14, 2010, 9:30 a.m.-10:30 a.m.
Session Title: DES I and Acute Coronary Syndromes Abstract Category: Vulnerable Plaque Presentation Number: 2501-495 Authors: Patrick A. Calvert, Daniel Obaid, Nick E. West, Leonard M. Shapiro, Duncan McNab, Cameron G. Densem, Peter M. Schofield, Denise Braganza, Sarah C. Clarke, Michael O’Sullivan, Kausik K. Ray, Martin R. Bennett, Division of Cardiovascular Medicine, University of Cambridge, Cambridge, United Kingdom, Papworth NHS Foundation Trust Hospital, Cambridge, United Kingdom Background: Previous work has focused on the relationship between plaque virtual-histology intravascular ultrasound (VH-IVUS) appearances (local coronary factors) and patient presentation. Little is known about the relationship between patient presentation and the VH-IVUS appearances of the whole coronary artery vascular tree (global coronary factors), which may be a better “barometer” of patients’ cardiovascular risk. This study aims to determine which VH-IVUS coronary factors, local or global, discriminate better between stable angina and troponin positive acute coronary syndrome (ACS). Methods: This 200 patient cross-sectional study examined the VH-IVUS appearances of the whole coronary artery vascular tree (full 3-vessel VHIVUS) in patients referred for percutaneous coronary intervention (PCI) with either stable angina or ACS. VH-IVUS imaging preceded PCI. Results are presented as mean ± standard deviation unless stated. Results: There were no differences in the baseline demographics between the stable angina and ACS groups including age, sex, blood pressure, previous MI, diabetes, cholesterol ratio and smoking. Diabetic patients had a greater necrotic core volume on full 3-vessel VH-IVUS than nondiabetics: 282±176mm3 vs. 116±70mm3, p = 0.017. However, diabetics had a greater plaque burden than non-diabetics: 1811±695mm3 vs. 1092±398mm3, p = 0.002. After adjusting for total plaque volume, diabetics still had more necrotic core volume than non-diabetics: 14.4±5.0% vs. 10.1±4.0%, p = 0.006. There was no difference on full 3-vessel VH-IVUS necrotic core volume between the stable angina and ACS groups, even after adjusting for total plaque volume: 11.0±4.0% vs. 11.1±4.7%, p = 0.943. However, ACS patients were more likely to have at least one VH-IVUS derived thin-capped fibroatheroma (ID-TCFA) in the target vessel than stable angina patients: odds ratio = 4.9 (95% CI = 1.4 to 17.1), p = 0.016. Conclusion: Although global coronary factors (whole coronary artery plaque burden and necrotic core volume) may define high risk patient populations such as diabetics, local factors such as presence of ID-TCFA in the target vessel may be more important in governing mode of patient presentation.
i2 SUMMIT WHICH VIRTUAL HISTOLOGY INTRAVASCULAR ULTRASOUND PROPERTIES DISCRIMINATE BETTER BETWEEN STABLE ANGINA PECTORIS AND TROPONIN POSITIVE ACUTE CORONARY SYNDROME ASSESSMENT OF PLAQUES OR ANALYSIS OF THE WHOLE CORONARY ARTERY VASCULATURE? i2 Poster Contributions Georgia World Congress Center, Hall B5 Sunday, March 14, 2010, 9:30 a.m.-10:30 a.m.
Session Title: DES I and Acute Coronary Syndromes Abstract Category: Vulnerable Plaque Presentation Number: 2501-495 Authors: Patrick A. Calvert, Daniel Obaid, Nick E. West, Leonard M. Shapiro, Duncan McNab, Cameron G. Densem, Peter M. Schofield, Denise Braganza, Sarah C. Clarke, Michael O’Sullivan, Kausik K. Ray, Martin R. Bennett, Division of Cardiovascular Medicine, University of Cambridge, Cambridge, United Kingdom, Papworth NHS Foundation Trust Hospital, Cambridge, United Kingdom Background: Previous work has focused on the relationship between plaque virtual-histology intravascular ultrasound (VH-IVUS) appearances (local coronary factors) and patient presentation. Little is known about the relationship between patient presentation and the VH-IVUS appearances of the whole coronary artery vascular tree (global coronary factors), which may be a better “barometer” of patients’ cardiovascular risk. This study aims to determine which VH-IVUS coronary factors, local or global, discriminate better between stable angina and troponin positive acute coronary syndrome (ACS). Methods: This 200 patient cross-sectional study examined the VH-IVUS appearances of the whole coronary artery vascular tree (full 3-vessel VHIVUS) in patients referred for percutaneous coronary intervention (PCI) with either stable angina or ACS. VH-IVUS imaging preceded PCI. Results are presented as mean ± standard deviation unless stated. Results: There were no differences in the baseline demographics between the stable angina and ACS groups including age, sex, blood pressure, previous MI, diabetes, cholesterol ratio and smoking. Diabetic patients had a greater necrotic core volume on full 3-vessel VH-IVUS than nondiabetics: 282±176mm3 vs. 116±70mm3, p = 0.017. However, diabetics had a greater plaque burden than non-diabetics: 1811±695mm3 vs. 1092±398mm3, p = 0.002. After adjusting for total plaque volume, diabetics still had more necrotic core volume than non-diabetics: 14.4±5.0% vs. 10.1±4.0%, p = 0.006. There was no difference on full 3-vessel VH-IVUS necrotic core volume between the stable angina and ACS groups, even after adjusting for total plaque volume: 11.0±4.0% vs. 11.1±4.7%, p = 0.943. However, ACS patients were more likely to have at least one VH-IVUS derived thin-capped fibroatheroma (ID-TCFA) in the target vessel than stable angina patients: odds ratio = 4.9 (95% CI = 1.4 to 17.1), p = 0.016. Conclusion: Although global coronary factors (whole coronary artery plaque burden and necrotic core volume) may define high risk patient populations such as diabetics, local factors such as presence of ID-TCFA in the target vessel may be more important in governing mode of patient presentation.