Prospective validation that vulnerable plaque associated with major adverse outcomes have larger plaque volume, less dense calcium, and more non-calcified plaque by quantitative, three-dimensional measurements using intravascular ultrasound with radiofrequency backscatter analysis : results from the ATLANTA I Study

J Cardiovasc Transl Res. 2013 Oct;6(5):762-71. doi: 10.1007/s12265-013-9473-0. Epub 2013 May 22.

Abstract

Whether quantitative, two-dimensional, and three-dimensional plaque measurements by intravascular ultrasound with radiofrequency backscatter (IVUS/VH) are different between intermediate lesions with or without major adverse cardiovascular events (MACE) is unknown. IVUS/VH-derived parameters were compared in 60 patients with an intermediate coronary lesion (40-70 %) between lesions that did or did not result in MACE over 12 months. IVUS/VH measurements were done at the site of the minimal lumen area (MLA) and on a per-plaque basis, defined by 40 % plaque burden. Pre-specified, adjudicated MACE events occurred in 5 of 60 patients (8.3 %). MACE lesions had larger plaque burden (65 % vs. 53 %, p = 0.004), less dense calcium (6.6 % vs. 14.7 %, p = 0.05), and more non-calcified plaque, mostly fibrofatty kind (17.6 % vs. 10 %, p = 0.02). Intermediate coronary lesions associated with MACE at 12 months have more plaque, less dense calcium, and more non-calcified plaque, particularly fibrofatty tissue by IVUS/VH.

Trial registration: ClinicalTrials.gov NCT00817102.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Aged
  • Coronary Angiography / methods
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Vessels / diagnostic imaging*
  • Disease Progression
  • Female
  • Fibrosis
  • Georgia
  • Humans
  • Image Interpretation, Computer-Assisted*
  • Imaging, Three-Dimensional*
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Necrosis
  • Odds Ratio
  • Plaque, Atherosclerotic*
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Reproducibility of Results
  • Risk Factors
  • Scattering, Radiation
  • Severity of Illness Index
  • Time Factors
  • Tomography, X-Ray Computed
  • Ultrasonography, Interventional / methods*
  • Vascular Calcification / complications
  • Vascular Calcification / diagnostic imaging*

Associated data

  • ClinicalTrials.gov/NCT00817102