Correlation between the plaque burden and remodeling in patients with acute coronary syndrome

doi:10.3877/cma.j.issn.1672-6448.2015.06.007

Abstract

Abstract:

Objective

To discuss the potential relationship of plaque burden (PB) and coronary remodeling in acute coronary syndrome (ACS) patients.

Methods

Ninety-one patients with ACS in Qingdao Municipal Hospital during January 2011 to June 2014 underwent the conventional coronary angiography and intravascular ultrasonography (IVUS). The remodeling of 60 cases were positive (remodeling index [RI]>1) and those of 31 cases were negative (RI<1). All 91 patients were included in this study, including 9 cases (PB<60%), 19 cases (60%≤PB<70%), 48 cases (70%≤PB<80%) and 15 cases (PB>80%). The difference of plaque cross-sectional area (P-CSA), lumen cross-sectional area (L-CSA), external elastic membrane cross-sectional area (EEM-CSA), average EEM-CSA, PB between positive remodeling and negative remodeling were compared by independent-samples t test. ANOVA was used to compare P-CSA, L-CSA, EEM-CSA and RI among patients with different PB. The relevance of PB, P-CSA, EEM-CSA, L-CSA and RI were analyzed by Pearson correlation analysis.

Results

There were no significant differences in P-CSA, L-CSA, EEM-CSA and PB between patients with positive remodeling and negative remodeling. Average EEM-CSA of patients with negative remodeling were significantly greater than that of patients with positive remodeling [(13.24±1.98) mm² vs (17.30±3.16) mm², t=2.46, P<0.05]. P-CSA, EEM-CSA and L-CSA had significant differences (F=24.56, 28.97 and 7.14, P<0.001) while RI had not statistical significant difference among patients with different PB. With the increase of PB, P-CSA and EEM-CSA increased [P-CSA: (6.01±1.68), (9.12±2.00), (11.42±2.05) and (14.05±4.00) mm², EEM-CSA: (11.43±1.90), (13.64±2.93), (15.14±2.64) and (16.64±4.08) mm²], L-CSA reduced [(5.44±0.89), (4.52±0.99), (3.72±0.74) and (2.60±0.63) mm²]. PB was positively correlated with P-CSA and EEM CSA (r=0.76, 0.50, P<0.001), but was negatively correlated with L-CSA (r=-0.74, P<0.001). RI had no relationship with PB, P-CSA, L-CSA and EEM-CSA.

Conclusions

Coronary artery remodeling is a very complicated dynamic process. Except the PB, other factors probably affect the direction of remodeling. RI is not suitable as the index for the assessment of vascular remodeling.

Key words: Acute coronary syndrome, Ultrasonography, interventional, Plaque burden

Hongshuai Shen, Dalin Song, Meilian Wei, Weiqiang Kang. Correlation between the plaque burden and remodeling in patients with acute coronary syndrome[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2015, 12(06): 446-452.

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Figures/Tables 6

References 31

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组别		例数	年龄（岁，±s）	性别（例，男性/女性）	高血压病史（例，是/否）	糖尿病史（例，是/否）	吸烟史（例，是/否）
正性重构组		60	58.4 ± 11.9	35/25	31/29	12/48	33/27
负性重构组		31	60.8 ± 8.7	26/5	18/13	7/24	11/20
?	检验值	?	t=-1.1	χ²=6.03	χ²=0.34	χ²=0.08	χ²=3.12
?	P值	?	0.28	0.01	0.56	0.77	0.08

组别		例数	年龄（岁，±s）	性别（例，男性/女性）	高血压病史（例，是/否）	糖尿病史（例，是/否）	吸烟史（例，是/否）
正性重构组		60	58.4 ± 11.9	35/25	31/29	12/48	33/27
负性重构组		31	60.8 ± 8.7	26/5	18/13	7/24	11/20
?	检验值	?	t=-1.1	χ²=6.03	χ²=0.34	χ²=0.08	χ²=3.12
?	P值	?	0.28	0.01	0.56	0.77	0.08

组别		例数	性别（例，男性/女性）	年龄（岁，±s ）	高血压病史（例，是/否）	糖尿病史（例，是/否）	吸烟史（例，是/否）
PB<60%		9	4/5	61.1 ± 12.5	6/3	2/7	2/7
60%≤PB<70%		19	11/8	57.6 ± 11.9	11/8	6/13	8/11
70%≤PB<80%		48	34/14	58.6 ± 10.5	26/22	10/38	27/21
PB>80%		15	12/3	62.1 ± 10.5	6/9	1/14	7/8
?	检验值	?	χ²=4.25	F=0.61	χ²=1.88	χ²=3.16	χ²=3.97
?	P值	?	0.24	0.61	0.60	0.37	0.26

组别		例数	性别（例，男性/女性）	年龄（岁，±s ）	高血压病史（例，是/否）	糖尿病史（例，是/否）	吸烟史（例，是/否）
PB<60%		9	4/5	61.1 ± 12.5	6/3	2/7	2/7
60%≤PB<70%		19	11/8	57.6 ± 11.9	11/8	6/13	8/11
70%≤PB<80%		48	34/14	58.6 ± 10.5	26/22	10/38	27/21
PB>80%		15	12/3	62.1 ± 10.5	6/9	1/14	7/8
?	检验值	?	χ²=4.25	F=0.61	χ²=1.88	χ²=3.16	χ²=3.97
?	P值	?	0.24	0.61	0.60	0.37	0.26

组别	例数	P-CSA （mm²）	L-CSA （mm²）	EEM-CSA （mm²）	平均EEM-CSA （mm²）	PB（%）
正性重构组	60	10.45 ± 2.73	3.90 ± 1.00	14.35 ± 2.88	13.24 ± 1.98	72.03 ± 9.14
负性重构组	31	11.59 ± 4.01	3.82 ± 1.31	15.41 ± 3.72	17.30 ± 3.16	73.87 ± 10.36
t值	?	-1.6	0.33	-1.5	2.46	-0.87
P值	?	0.11	0.75	0.14	0.02	0.39

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