Patients with more coronary yellow plaques have higher risk of stenosis progression within 7 months

Abstract

Disruption of vulnerable plaques causes acute coronary syndrome and stenosis progression. Yellow plaques are regarded as vulnerable and the number of yellow plaques per vessel (NYP) has been reported as a marker of vulnerable patients. Therefore, we examined if patients with more yellow plaques would have higher risk of stenosis progression. A series of patients (n = 70) who received percutaneous coronary intervention (PCI) and angioscopy was included. Patients were divided into 2 groups according to NYP: group 1 (NYP <4, n = 32) and group 2 (NYP ≥ 4, n = 38). Coronary artery stenosis progression in any segment excluding target lesion of PCI was examined by angiography at 7 months. Maximum yellow color grade of yellow plaques (2.7 ± 0.7 vs. 1.7 ± 1.2, p < 0.0001) and the number of non-target disrupted yellow plaques was larger in group 2 than in group 1 (1.1 ± 1.5 vs. 0.2 ± 0.6, p=0.0017). Progression of coronary stenosis was detected more frequently in group 2 than in group 1 (29% vs. 9%, p = 0.041). The number of sites with stenosis progression was larger in group 2 than in group 1 (0.47 ± 0.98 vs. 0.09 ± 0.30 sites/patient, p = 0.036). Vulnerable patients with more yellow plaques had higher incidence of stenosis progression. Approximately 30% of vulnerable patients with NYP ≥ 4 had stenosis progression within 7 months.