scholarly journals Coronary Plaque Structural Stress Is Associated With Plaque Composition and Subtype and Higher in Acute Coronary Syndrome

2014 ◽  
Vol 7 (3) ◽  
pp. 461-470 ◽  
Author(s):  
Zhongzhao Teng ◽  
Adam J. Brown ◽  
Patrick A. Calvert ◽  
Richard A. Parker ◽  
Daniel R. Obaid ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Plaque ◽  
Structural Stress ◽  
Plaque Composition ◽  
Coronary Syndrome

Abstract 2003: The Characteristics of Non-Culprit Coronary Plaques in Patients with Acute Coronary Syndrome: Noninvasive Assessment by 64-Slice Computed Tomography

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Hirohiko Ando ◽  
Tetsuya Amano ◽  
Tadayuki Uetani ◽  
Michio Nanki ◽  
Nobuyuki Marui ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Intervention ◽  
Coronary Plaque ◽  
Plaque Composition ◽  
Fibrous Plaque ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Remodeling Index ◽  
Coronary Lesions ◽  
Soft Plaque

Some invasive imaging modalities such as intravascular ultrasound and angioscopy have shown the vulnerability of non-culprit plaques in patients with acute coronary syndrome (ACS). Recently multi-slice CT (MSCT) has been used to assess the characteristics of coronary plaque and the major advantage of MSCT is that it can evaluate all coronary plaques noninvasively. The purposes of this study are to assess coronary plaques noninvasively by MSCT and compare the differences of plaque composition between culprit and non-culprit lesions in patients with ACS and stable lesions in the patients with stable angina pectoris (SAP). 64-slice CT was performed in 27 patients with ACS and 33 patients with SAP before percutaneous coronary intervention. According to CT value, we defined plaque components as soft plaque (SP <50 HU), fibrous plaque (50 HU <FP <150 HU) and calcified plaque (CP >500 HU). In all obstructive lesions, we evaluated plaque characteristics by calculating the volume of SP, FP and CP. On the basis of clinical presentation, electrocardiogram and angiographic appearance, coronary lesions in the patients with ACS are divided into culprit or non-culprit lesions. Coronary lesions in the patients with SAP are defined as stable lesions. We analyzed 89 lesions with excellent image quality. Culprit lesions (n=19) and non-culprit lesions (n=25) had significantly larger volumetric percentage of SP and higher remodeling index compared to stable lesions (n=40) (34.4% vs. 29.3% vs. 21.0%, p<0.0001 and 1.061 vs. 1.061 vs. 0.971, p=0.01, respectively). But there was no significant difference in plaque composition between culprit lesions and non-culprit lesions. We assessed coronary plaques noninvasively by MSCT and found that non-culprit lesions in the patients with ACS, as well as culprit lesions, had significantly larger volumetric percentage of SP and higher remodeling index compared to stable lesions in the patients with SAP, supporting the concept of multiple vulnerable plaques in patients with ACS.

scholarly journals Impact of Total Risk Management on Coronary Plaque Regression in Diabetic Patients with Acute Coronary Syndrome

2016 ◽  
Vol 23 (8) ◽  
pp. 922-931 ◽  
Author(s):  
Ryo Naito ◽  
Katsumi Miyauchi ◽  
Hiroyuki Daida ◽  
Takeshi Morimoto ◽  
Takafumi Hiro ◽  
...  
Keyword(s):  
Risk Management ◽  
Acute Coronary Syndrome ◽  
Coronary Plaque ◽  
Diabetic Patients ◽  
Total Risk ◽  
Coronary Syndrome ◽  
Plaque Regression

scholarly journals Effects of 4 Statins on Regression of Coronary Plaque in Acute Coronary Syndrome

2016 ◽  
Vol 80 (7) ◽  
pp. 1634-1643 ◽  
Author(s):  
Kensuke Matsushita ◽  
Kiyoshi Hibi ◽  
Naohiro Komura ◽  
Eiichi Akiyama ◽  
Nobuhiko Maejima ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Plaque ◽  
Coronary Syndrome

Abstract 14134: Effects of Statin Plus Ezetimibe versus Statin Alone on Coronary Atherosclerosis in Acute Coronary Syndrome

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Kiyoshi Hibi ◽  
Kazuo Kimura ◽  
Shinjo Sonoda ◽  
Yutaka Otsuji ◽  
Toyoaki Murohara ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Combination Therapy ◽  
Therapy Group ◽  
Combined Therapy ◽  
Coronary Plaque ◽  
Statin Treatment ◽  
Combination Therapy Group ◽  
Plaque Volume ◽  
Coronary Syndrome ◽  
Percent Change

Introduction: IMPROVE-IT trial showed that ezetimibe plus statin treatment, as compared with statin alone, decreased cardiovascular events in patients with acute coronary syndrome (ACS). However, proir studies have failed to show a beneficial effect of ezetimibe on carotid plaque progression when added to statin treatment. Hypothesis: The addition of ezetimibe to statin therapy affects coronary plaque behavior in the non-culprit vessel. Methods: We conducted a prospective, randomized open-label parallel group study with blind endpoint evaluation conducted at 10 centers in Japan. A total of 128 statin naïve patients with ACS undergoing intravascular ultrasound (IVUS) guided percutaneous coronary intervention were randomized and nonculprit coronary lesions associated with mild-to-moderate stenosis in 103 patients had evaluable IVUS examinations at baseline and at 8 to 12 months follow-up. Conventional IVUS and integrated backscatter (IB)-IVUS measurements at 1-mm intervals were calculated. Patients were randomly assigned to receive either 2mg/day of pitavastatin plus 10mg/day ezetimibe or 2mg/day of pitavastatin. Primary endpoints were the percentage change in non-culprit coronary plaque volume and percent change in lipid plaque volume. Results: Mean low density lipoprotein cholesterol was reduced from 125mg/dl to 65mg/dl in the combination therapy group receiving statin plus ezetimibe (n=50) and 126mg/dl to 87 mg/dl in the statin alone group (n=53)(between group difference of 16.9%, P<0.0001). Length of analyzed segment did not differ between the groups (median 38.0 vs. 41.2 mm, p=0.40). The primary endpoint, percent change in plaque volume, was -5.1% in the combination therapy group and -6.2% in the statin alone group (P=0.66), although both groups resulted in reduction of plaque volume compared with baseline (both p=0.001). The percent change in lipid plaque volume did not differ between the groups (4.3 vs. -3.0%, P=0.37). Conclusions: Among patients with acute coronary syndrome, combined therapy with ezetimibe and statin did not result in a significant change in coronary plaque regression or tissue component compared with statin alone.

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