Abstract
ObjectiveWe used virtual histology-intravascular ultrasound (VH-IVUS) to evaluate the relation between coronary artery remodeling pattern and plaque components in 1133 patients. MethodsWe divided the patients into two groups according to the remodeling pattern as positive remodeling (PR, remodeling index>1.05) (n=192) and intermediate remodeling (IR, remodeling index≤1.05 and ≥0.95)/negative remodeling (NR, remodeling index<0.95) (n=941). VH-IVUS analysis classified the color-coded tissue into four major components: green (fibrotic, FT); yellow–green (fibro-fatty); white (dense calcium); and red (necrotic core, NC). Thin-cap fibroatheroma (TCFA) was defined as focal, NC-rich (≥10% of the cross-sectional area) plaques being in contact with the lumen in a plaque burden≥40%. ResultsAt the minimum lumen site, PR group had greater plaque plus media area (12.8±4.9 vs. 9.9±3.8mm2, p<0.001) and greater %NC area (21.7±12.3 vs. 18.2±11.6%, p<0.001) and smaller %FT area (57.0±14.5 vs. 59.4±14.6%, p=0.037) compared with IR/NR group. PR group had greater plaque volume (188±150 vs. 135±130mm3, p<0.001) and greater %NC volume (19.1±9.6 vs. 16.6±9.2%, p=0.001) and smaller %FT volume (58.3±11.7 vs. 60.6±11.0%, p=0.009) compared with IR/NR group. PR group had more TCFA compared with IR/NR group (21% vs. 13%, p=0.006). Similar findings about plaque components were observed in terms of greater %NC volume and smaller %FT volume in PR group compared with IR/NR group in patients with both acute coronary syndrome and stable angina. ConclusionsVH-IVUS analysis demonstrates that PR was associated with more vulnerable plaque components compared with IR/NR regardless of their clinical presentation.
Published Version
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