급성 관상동맥 증후군 환자에서 병변의 특성：혈관 내 초음파를 이용한 안정형 협심증 환자와의 비교분석

Abstract

The pathophysiology of acute coronary syndrome (ACS) is plaque rupture with thrombus formation, which is different from that of stable angina pectoris (SA). Intravascular ultrasound (IVUS) prior to percutaneous coronary intervention provides information on the plaques and vessel wall itself. The purpose of this study was to evaluate the lesion characteristics of ACS prior to coronary intervention compared to those of SA lesions by IVUS. Subjects and Methods：Pre-interventional IVUS was performed on 68 culprit lesions in 41 ACS and 25 SA patients. The plaque morphology, lumen and vessel sizes, and arterial remodeling pattern at the lesion segment were analyzed in both groups. A plaque rupture was defined as a plaque containing a cavity that communicated with the lumen, which was covered with a fibrous cap. Results：Positive remodeling was more frequent in patients with ACS than those with SA (42 vs. 11%), whereas negative remodeling was more frequent in patients with SA (22 vs. 41%) (p=0.023). Plaque rupture/dissection and thrombus was more frequent (51 vs. 19%, p=0.006 and 39 vs. 4%, p=0.001) in patients with ACS. Lesions with ACS had significantly larger EEM CSA, plaque CSA and plaque burden (p