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Difference of culprit plaque composition between patients with and without pre-infarction angina: an intravascular

Yasutomi Higashikuni1, Kengo Tanabe, Shuzou Tanimoto

  • 1Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan.

Eurointervention : Journal of Europcr in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
|September 9, 2009
PubMed

Insights

Patients with pre-infarction angina (PA) have different culprit plaque composition compared to those without PA. Necrotic core components were higher in patients without PA, while fibrofatty components were higher in patients with PA.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Imaging

Background:

  • Pre-infarction angina (PA) is a clinical manifestation of acute coronary syndromes.
  • Understanding culprit plaque composition is crucial for predicting cardiovascular events.

Purpose of the Study:

  • To investigate the differences in culprit plaque composition between patients with and without pre-infarction angina (PA).
  • To utilize spectral analysis of intravascular ultrasound (IVUS) radiofrequency (RF) data for plaque characterization.

Main Methods:

  • Intravascular ultrasound (IVUS) radiofrequency (RF) data were analyzed from culprit plaques of 35 patients with acute myocardial infarction.
  • Patients were categorized into groups with and without pre-infarction angina (PA).
  • Plaque composition, specifically necrotic core and fibrofatty components, was quantified at the minimum lumen area (MLA) site and entire culprit lesion.

Main Results:

  • Patients without PA exhibited a significantly higher percentage of necrotic core component in culprit plaques compared to those with PA (MLA site: 21.2% vs 9.9%, p=0.0015; entire lesion: 18.9% vs 12.0%, p=0.023).
  • Conversely, patients with PA showed a higher percentage of fibrofatty component in culprit plaques (MLA site: 21.0% vs 11.5%, p=0.013; entire lesion: 16.8% vs 12.1%, p=0.062).
  • No significant differences in quantitative plaque parameters were observed between the two groups.

Conclusions:

  • Culprit plaque composition differs significantly between patients with and without pre-infarction angina (PA).
  • Plaque composition, characterized by necrotic core and fibrofatty content, may play a critical role in the development of PA.
  • These findings highlight the importance of plaque characterization in managing patients with acute coronary syndromes.
Abstract

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