on October 18, 2004
Published online before print October 18, 2004, doi: 10.1161/01.CIR.0000146337.05073.22
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Submitted on March 30, 2004
From the Department of Hemodynamics and Interventional Cardiology, Cardiovascular Hospital and Claude Bernard University, Lyon (G.R., G.F., I.G., X.A.-F.), and Department of Cardiology, "La Cavale Blanche" University Hospital, Brest (M.G., J.B.), France. * To whom correspondence should be addressed. E-mail: gilles.rioufol{at}univ-lyon1.fr.
Background--Ruptured coronary atheromatous plaque is generally considered to involve a high risk of subsequent clinical events. Few data are available on the natural evolution of non-culprit-lesion ruptured plaque. We therefore used serial intravascular ultrasound (IVUS) to study how such lesions, detected in the context of a first acute coronary syndrome with elevated troponin I levels, develop. Methods and Results--Fourteen patients with 28 distinct plaque ruptures (2±1 per patient) without significant associated stenosis (minimal lumen cross-sectional area >4 mm2) were included and systematically treated with 40 mg statin and antiplatelet agent (clopidogrel and aspirin for Conclusions--Nearly 2 years of follow-up found that spontaneous coronary atheromatous plaque rupture without significant stenosis detected on first acute coronary syndrome healed without significant plaque modification in 50% of cases with medical therapy.
Revised on May 28, 2004
Accepted on July 13, 2004
Evolution of Spontaneous Atherosclerotic Plaque Rupture With Medical Therapy. Long-Term Follow-Up With Intravascular Ultrasound
Gilles Rioufol MD, PhD*,
9 months). Mean clinical and IVUS follow-up was 22±13 months (median, 22 months). No clinical event related to the lesion under study occurred. On final IVUS examination, half (14 of 28) of the ruptured plaques had healed, and the degree of stenosis tended to diminish (stenosis, 22±17% versus 29±17% at baseline; P=0.056). No healing-prediction criterion could be identified.
Key words: atherosclerosis • cardiovascular diseases • catheterization • imaging • ultrasonics
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