Abstract 12301: Syntax Score Reflects Coronary Plaque Characteristics Assessed by Integrated Backscatter Intravascular Ultrasound
Background: It has been proven that some coronary risk factors such as diabetes mellitus, have influence on coronary plaque characteristics assessed by intravascular ultrasound (IVUS). However, the relationship between components and complexity of coronary lesions has not been precisely investigated.
Purpose: To elucidate the relationship between components of coronary plaques assessed by integrated backscatter IVUS (IB-IVUS) and complexity of coronary lesions quantified by SYNTAX (SYNergy between PCI with TAXUS and Cardiac Surgery) score.
Method: A total of 85 de novo lesions in 73 patients who underwent pre-procedural IB-IVUS analysis were classified based on SYNTAX score: low (1 to 7: n=29), medium (8 to 11: n=31), and high score group (12 to 20: n=25). Tissue characteristics of the culprit lesions (10mm length including minimal lumen area) were analyzed using IB-IVUS and plaque components of each stenotic lesion were divided into four categories: calcified, dense-fibrotic, fibrotic, and lipidic.
Result: There were no significant differences in baseline characteristics including coronary risk factors, vessel area, and total plaque volume of the lesions among three groups. Calcified components, dense-fibrotic components, and fibrotic components were significantly larger, and lipidic component was significantly smaller in the high score group than those of the low and medium score groups. An exception to this was the fibrotic component between high and medium score group (Table).
Conclusion: The strong relationship between complexity of the lesions quantified by SYNTAX score and plaque components analyzed by IB-IVUS was demonstrated. The higher SYNTAX score, the more fibrosis and calcification were found in the plaque. These results suggest that it is necessary to care about under-expansion due to hard plaque in the high SYNTAX score and distal embolization due to high lipid contents within the plaques in lower SYNTAX score.
- © 2011 by American Heart Association, Inc.