812-4 Efficacy of Angioscopic Findings for Prediction of Cardiac Events In Patients with Chronic Ischemic Heart Disease

Abstract

We have previously demonstrated that yellow plaque (YP) was frequently observed in patients (pts) with acute coronary syndrome. We hypothesized that YP might be consisted of a thin fibrous cap to cause easily cardiac events (CEs; acute myocardial infarction, unstable angina, sudden cardiac death) in pts with ischemic heart disease (IHD). To address this issue, we performed percutaneous transluminal coronary angioscopy (PTCAS) in 37 pts (65 ± 8 years, 20 male) with chronic IHD. Angioscopic findings were made by two blinded observers and were compared with coronary angiography (CAG). Pts were classified into two groups according to the interpretation of lesions; group YP (9 pts, 58 ± 9 years) and group white (W, 28 pts, 66 ± 14 years). By CAG, lesions were interpreted in same manner and categorized as a filling defect, a hazy lesion or a smooth stenosis. All pts were then followed up for 12 months and their subsequent CEs were carefully checked in our outpatient clinic at least in every two to four weeks. In YP group, CEs were found in 4/9 pts, whereas in WP group, CEs were found only in 1/28 pts (p < 0.05 vs. YP). However CAG morphology could not get any significant different between CE and non CE pts. (1) YP had a higher risk to culminate in CEs within one year. Thus YP might be consisted of vulnerable thinner P that would be easily ruptured by weak stimuli. (2) To predict CEs in chronic stable IHD, PTCAS is better than CAG.