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Comparison of Inravascular Ultrasound and Histological Findings in Culprit Coronary Plaques Between ST-Segment Elevation and Non-ST-Segment Elevation Myocardial Infarction

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Author(s)
황일선
Alternative Author(s)
Hwang, Il Seon
Publication Year
2013
Abstract
It remains uncertain whether the histology of culprit coronary plaques differs between
ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). We
compared intravascular ultrasound (IVUS) and histologic findings in coronary culprit
plaques among patients presenting with STEMI and NSTEMI. Atherectomy specimens
were obtained from 96 patients, 70 with STEMI and 26 with NSTEMI, who underwent
directional coronary atherectomy for de novo coronary artery lesions. IVUS examinations
were performed before directional coronary atherectomy. IVUS and histologic data were
analyzed. Clinical characteristics were largely similar between the 2 groups; however,
normal antegrade flow before angioplasty was less frequently observed in patients with
STEMI than those with NSTEMI. Plaque rupture was more common on the proximal side
of the minimal lumen site. There were no differences in vessel area, lumen area, calcification,
plaque burden, or remodelling index at the reference and culprit sites. However, the
arc of the ruptured cavity was significantly greater in patients with STEMI than those with
NSTEMI (69.4 – 27.9 vs 51.8 – 20.0 , respectively, p [ 0.008). The proportion of
atheroma, fibrocellular, and thrombus areas was not different between the 2 groups.
Similarly, the relative areas immunopositive for CD31, smooth muscle a-actin, and CD68
were similar in the 2 groups. In conclusion, coronary culprit lesions in patients with STEMI
show more severe plaque rupture with similar histologic features than those in patients with
NSTEMI, supporting the idea that a large plaque rupture is more likely in STEMI
patients. 2013 Elsevier Inc. All rights reserved. (Am J Cardiol 2013;112:68e72)
Department
Dept. of Pathology (병리학)
Publisher
School of Medicine
Citation
American Journal of Cardiology, Vol.112(1) : 68-72, 2013
Type
Article
ISSN
0002-9149
DOI
10.1016/j.amjcard.2013.02.050
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/34888
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