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Multiple Atherosclerotic Plaque Rupture in Acute Coronary Syndrome ; A Three-Vessel Intravascular Ultrasound Study

Title: Multiple Atherosclerotic Plaque Rupture in Acute Coronary Syndrome ; A Three-Vessel Intravascular Ultrasound Study
Authors: Rioufol, G.; Finet, G.; Ginon, I.; André-Fouët, X.; Rossi, R.; Vialle, E.; Desjoyaux, E.; Convert, G.; Huret, J.F.; Tabib, A.
Source: Circulation ; volume 106, issue 7, page 804-808 ; ISSN 0009-7322 1524-4539
Publisher Information: Ovid Technologies (Wolters Kluwer Health)
Publication Year: 2002
Description: Background— To test the hypothesis of general atherosclerotic plaque destabilization during acute coronary syndrome (ACS), the present study sought to analyze the 3 coronary arteries by systematic intravascular ultrasound scan (IVUS). Methods and Results— Seventy-two arteries were explored in 24 patients referred for percutaneous coronary intervention after a first ACS with troponin I elevation. Fifty plaque ruptures (mean, 2.08 per patient; range, 0 to 6) were diagnosed by the association of a ruptured capsule with intraplaque cavity. Plaque rupture on the culprit lesion was found in 9 patients (37.5%). At least 1 plaque rupture was found somewhere other than on the culprit lesion in 19 patients (79%). These lesions were in a different artery than the culprit artery in 70.8% and were in both other arteries in 12.5% of these 24 patients. Complete IVUS examination of all 3 coronary axes in patients who had experienced a first ACS revealed that multiple atherosclerotic plaque ruptures were detected by IVUS; these multiple ruptures were present simultaneously with the culprit lesion; they were frequent and located (in three quarters of cases) on the 3 principal coronary trunks; and the multiple plaque ruptures in locations other than on the culprit lesion were less severe, nonstenosing, and less calcified. Conclusion— Although one single lesion is clinically active at the time of ACS, the syndrome seems nevertheless associated with overall coronary instability.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1161/01.cir.0000025609.13806.31
DOI: 10.1161/01.CIR.0000025609.13806.31
Availability: https://doi.org/10.1161/01.cir.0000025609.13806.31; https://www.ahajournals.org/doi/full/10.1161/01.CIR.0000025609.13806.31
Accession Number: edsbas.B5767E27
Database: BASE