Abstract 2851: The Relation Between Coronary Calcification and Plaque Component for Patients with Acute Coronary Syndrome and Angina Pectoris: An IVUS Radiofrequency Data (VH-IVUS) Analysis
Background: Recently, potential association between atherosclerotic calcification and coronary plaque rupture has been suggested in acute coronary syndrome (ACS). However, the relation between coronary calcification and plaque component for ACS and stable angina (AP) using IVUS radiofrequency data (Virtual Histology: VH-IVUS) has not been clarified.
Methods: In 189 consecutive patients, the culprit vessel was investigated through spectral analysis of VH-IVUS as well as gray scale analysis. Diagnoses of cases were 51 ACS (includes acute myocardial infarction and unstable angina) and 138 AP. In gray scale, average lumen, plaque and vessel area were calculated for entire lesion segment. In VH analysis, moreover, absolute plaque value, relative component at pre-intervention and correlation among relative plaque component were measured within same segment.
Results: In gray scale, ACS lesions trended toward smaller average lumen area, larger vessel and plaque area compared with those of AP lesions (5.1±1.4 vs. 5.4±1.8, p=0.09, 14.9±4.3 vs. 14.3±4.2, p=0.20 and 9.7±3.6 vs. 9.1±3.7, p=0.32 for lumen, vessel and plaque area (mm2), ACS vs. AP for all). In VH, there was no difference in any absolute plaque value between two groups. However, in relative component analysis, dense calcium and necrotic core were significantly larger in the ACS group (Table⇓). Dense calcium and necrotic core were modestly correlated for both groups(r=0.55 vs. 0.49, p<0.01 for ACS vs. AP). Additionally, ACS group showed closer inverse correlation with fibrous plaque than AP group (r=−0.83 vs. −0.52, p<0.01 for ACS vs. AP).
Conclusion: These IVUS-VH analyses suggest that the mixture of dense calcium and necrotic core were frequent findings within ACS and AP lesions. The magnitude of dense calcium was inversely correlated with fibrous plaque, specifically in ACS lesions. These findings suggest the potential paradigm of atheromatous plaque rupture and/or erosion with healing and calcification.