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Peripheral atherosclerosis in acute coronary syndrome patients with plaque rupture vs plaque erosion: A prospective coronary optical coherence tomography and peripheral ultrasound study

医学 外围设备 急性冠脉综合征 心脏病学 内科学 罪魁祸首 血管内超声 冠状动脉粥样硬化 纤维帽 血管疾病 前瞻性队列研究 冠状动脉疾病 放射科 心肌梗塞
作者
Ziqian Weng,Chen Zhao,Yuhan Qin,Chun Yu Liu,Weili Pan,Sining Hu,Luping He,Yiyue Xu,Ming Zeng,Xue Feng,Rui Gao,Xianghao Yu,Minghao Liu,Boling Yi,Dirui Zhang,Ekaterina Koniaeva,Timur Ilgamovich Musin,Dahlia Abdal Hameed Abdal Magid Mohammad,Bo Zhu,Ying Sun,Jun Hou,Jie Tian,Gary S. Mintz,Haibo Jia,Bo Yu
出处
期刊:American Heart Journal [Elsevier]
卷期号:263: 159-168 被引量:2
标识
DOI:10.1016/j.ahj.2023.06.006
摘要

Plaque rupture (PR) and plaque erosion (PE) are 2 distinct, different, and most common culprit lesion morphologies responsible for acute coronary syndrome (ACS). However, the prevalence, distribution, and characteristics of peripheral atherosclerosis in ACS patients with PR vs PE has never been studied. The aim of this study was to assess peripheral atherosclerosis burden and vulnerability evaluated by vascular ultrasound in ACS patients with coronary PR vs PE identified by optical coherence tomography (OCT).Between October 2018 and December 2019, 297 ACS patients who underwent preintervention OCT examination of the culprit coronary artery were enrolled. Peripheral ultrasound examinations of carotid, femoral, and popliteal arteries were performed before discharge.Overall, 265 of 297 (89.2%) patients had at least one atherosclerotic plaque in a peripheral arterial bed. Compared with coronary PE, patients with coronary PR had a higher prevalence of peripheral atherosclerotic plaques (93.4% vs 79.1%, P < .001), regardless of location: carotid, femoral, or popliteal arteries. The number of peripheral plaques per patient was significantly larger in the coronary PR group than coronary PE (4 [2-7] vs 2 [1-5], P < .001). Additionally, there was a greater prevalence of peripheral vulnerable characteristics including plaque surface irregularity, heterogeneous plaque, and calcification in patients with coronary PR vs PE.Peripheral atherosclerosis exists commonly in patients presenting with ACS. Patients with coronary PR had greater peripheral atherosclerosis burden and more peripheral vulnerability compared to those with coronary PE, suggesting that comprehensive evaluation of peripheral atherosclerosis and multidisciplinary cooperative management maybe necessary, especially in patients with PR.clinicaltrials.gov (NCT03971864).
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