Abstract 15157: Coronary Plaque Component in Patients with Vasospastic Angina: A Virtual Histology Intravascular Ultrasound Study
Background: Coronary spasm plays an important role in the pathogenesis of ischemic heart disease. However, tissue components of coronary plaque in patients with vasospastic angina (VSA) have yet to be determined. Also, previous studies showed that female patients had more diffuse spasm than focal spasm compared with male patients. The present study used virtual histology (VH)-intravascular ultrasound (IVUS) to elucidate the tissue component of spastic coronary arteries and to assess the gender differences in patients with VSA.
Methods: Intracoronary injection of acetylcholine was done in 42 patients (19 men, 23 women, mean age, 61±13 years) with chest pain and normal angiograms. According to the results, the study subjects were divided into 2 groups: the VSA group of 26 patients (19LAD, 5LCX, 2RCA; 14 men, 12 women) and the non-VSA group of 16 patients (10LAD, 4LCX, 2RCA; 5 men, 11 women). After nitrate injection, an IVUS catheter was placed into the distal coronary artery and withdrawn automatically. Volumetric VH-IVUS parameters were compared between the 2 groups.
Results: Although clinical demographics were almost identical between the groups, VSA group had lower plasma adiponectin level (5.9±3.3μg/ml vs 11.2±7.6μg/ml, p=0.006) and tended to have higher high-sensitivity C-reactive protein (0.15±0.24mg/dl vs 0.06±0.04mg/dl, p=0.1) than non-VSA group. VSA group had diffusely thickened intima (% plaque volume, 34±11% vs 28±9%, p=0.04) compared with non-VSA group. However, plaque components of patients with VSA were quite similar with that of non-VSA patients (dense calcium, 4±6% vs 3±4%; necrotic core, 10±9% vs 8±6%; fibrofatty, 19±16% vs 22±11%; and fibrous, 67±16% vs 67±9%). There were no significant gender differences in the volumetric IVUS parameters and plaque components.
Conclusions: Compared with non-VSA patients, VSA patients had diffusely thickened fibrous-dominant coronary plaque without gender difference.
- © 2011 by American Heart Association, Inc.