Systemic and local factors associated with coronary plaque disruption

Thromb Res. 2012 Feb;129(2):164-8. doi: 10.1016/j.thromres.2011.09.009. Epub 2011 Oct 4.

Abstract

Introduction: Yellow plaques are regarded vulnerable; and disrupted yellow plaques are the major cause of acute coronary syndrome. We examined the factors associated with the disruption of yellow plaques among patients and lesion characteristics.

Materials and methods: Consecutive 161 patients with ischemic heart diseases who received coronary angioscopic examination were analyzed. Yellow plaques in the segments to which intervention had never been performed were included, and their yellow color grade and presence/ absence of disruption were examined. Associated factors for plaque disruption were examined among patients and lesion characteristics.

Results: In 161 patients, 392 yellow plaques were included for analysis and 70 of them were disrupted. Frequency of plaque disruption (=disrupted / all yellow plaques) was significantly higher at the segments of severer stenosis (stenosis≥75% vs. 75-25% vs. <25%: 34% vs. 21% vs. 14%, p=0.006). Multivariate analysis revealed angiographic stenosis (odds ratio [OR], 1.014; 95% confidence interval [CI], 1.005-1.023; p=0.003), yellow color grade (OR, 3.297; 95% CI, 2.062-5.273, p<0.001), LDL-cholesterol (OR, 1.012; 95% CI, 1.004-1.020, p=0.003), male gender (OR, 3.608; 95% CI, 1.538-8.465; p=0.003), and hypertension (OR, 2.552; 95% CI, 1.094-5.953; p=0.030) as significant associated factors for plaque disruption.

Conclusion: Angiographic stenosis, yellow color grade, LDL-cholesterol, male gender, and hypertension were significantly associated with the disruption of yellow plaques.

MeSH terms

  • Cholesterol, LDL / blood*
  • Comorbidity
  • Coronary Artery Disease / epidemiology*
  • Coronary Artery Disease / pathology*
  • Coronary Stenosis / blood
  • Coronary Stenosis / epidemiology*
  • Coronary Stenosis / pathology*
  • Female
  • Humans
  • Hypertension / blood
  • Hypertension / epidemiology*
  • Hypertension / pathology*
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Prevalence
  • Risk Assessment
  • Risk Factors
  • Sex Distribution

Substances

  • Cholesterol, LDL