Correlative Risk Factor Analysis of Culprit Lesion Plaque Composition in Patients With Acute Coronary Syndrome / 中国循环杂志

ABSTRACT

Objective: To evaluate the correlative risk factor of culprit lesion plaque composition in patients with acute coronary syndrome (ACS). Methods: A total of 55 ACS patients with 55 culprit vessels were divided into 2 groups:Unstable angina group, n=40 and AMI group, n=15. Coronary angiography (CAG) was conducted in all patients, the minimal lumen area and plaque burden at the minimal lumen area and the largest necrotic core were examined. Intravascular ultrasound with virtual histology (IVUS-VH) were performed to calculate the percentages of necrotic core area (NC%), dense calcium (DC%), ifbro-fatty area (FF%), ifbrous area (FI%) and to calculate the remodeling index. Plasma levels of matrix metalloproteinase-9 (MMP-9), oxidative low density lipoprotein (Ox-LDL) and hypersensitive c-reactive protein (hs-CRP) were also compared between 2 groups. Results: In AMI group and UAP group, NC%at minimal lumen area were (27.90 ± 9.72)%and (19.41 ± 11.53)%, t=-2.533, P=0.014;NC%at the largest necrotic core were (39.09 ± 8.82)%and (31.99 ±1 2.35)%, t=-2.032, P=0.047;plasma levels of MMP-9 were (14.63±2.71) μg/L and (12.65±2.72) μg/L, t=-2.411, P=0.019;Ox-LDL were (196.21±25.89) μg/L and (159.57±33.39) μg/L, t=-3.832, P=0.001;hs-CRP were (1.57±1.93) mg/L and (0.31±0.33) mg/L, t=-2.514, P=0.024 respectively. Plaque composition was not related to plasma levels of MMP-9, Ox-LDL and hs-CRP. In the largest necrotic core of cruprit lesion and the minimal lumen area, MLA were (5.25±2.15) mm2 and (3.45±1.07) mm2, t=-6.348, P=0.001;NC%were (33.93±11.85)%and (21.73±11.62)%, t=-8.752, P=0.001 respectively. Conclusion: ①Among ACS patients, AMI patients had the larger necrotic core area at cruprit lesion and higher MMP-9, Ox-LDL and hs-CRP.②There was no largest necrotic core composition at the minimal lumen area in the same cruprit lesion.③Plaque composition was not related to MMP-9, Ox-LDL and hs-CRP.