Author + information
- S1936879815021135-5c42646b401b3bd904914f1c24d7df66Sang Wook Kim1,
- S1936879815021135-a6c1bc52851ff7a2f92d51d27345d37fSang Yeub Lee2,
- S1936879815021135-c248b780362d81881c34029ac5979eb3Wang Soo Lee1,
- S1936879815021135-2e0d031504360d971ff3ba73d42edd65Saima Sharmin1,
- S1936879815021135-73712bc107d82793a1bd0ed77da9a8ecMayank Goyal1,
- S1936879815021135-21531d94e552db87277a1acb30f6befcMun Ki Jung1,
- S1936879815021135-534703e8b23846f1b666d6c90e9e8c5eYoung Kim1,
- S1936879815021135-b044fb11de64b07f4389c3fee16102a3Hoyoun Won1,
- S1936879815021135-22d57746d25c8ae4763c1a9fa48d59a7Seung Yong Shin1,
- S1936879815021135-1c898cc3ab6e44589b59c06e8d25ae34Kwang Je Lee1,
- S1936879815021135-9aa9adc7838cd366a2a81e6a1db16141Tae Ho Kim1 and
- S1936879815021135-484f81911ffa13a98fa759613a84fc5aChee Jeong Kim1
The microcalcification (MC) of fibrous cap might cause a unstable fibrous cap and provoke the plaque rupture and intracoronary thrombus.
We used optical coherent tomography (OCT) and Virtual histology intravascular ultrasound(VH-IVUS) to assess the MC in 264 pts with acute coronary syndrome (ACS). MC of the fibrous cap was diagnosed with OCT; and IVUS was used to determine arterial remodeling. Positive remodeling was a remodeling index (lesion/reference EEM [external elastic membrane] area) >1.05.
41 MC were assessed in the culprit lesion of 264 ACS pts. The mean age of MC was 59±11 yr, diabetes was 27% (11/41). The thickness of fibrous cap was 214±132 μm, and the thickness of MC was 219±110 μm which was in fibrous cap. The plaque composition beneath the fibous cap were fibrotic 29.1% (9/41), lipidic 24.4% (10/41), fibrocalcific 31.7% (13/41), thick cap fibroatheroma 17.1% (7/41), 4.9% (2/41) was thin-capped fibroatheroma. The remodeling index was 1.21±0.33 at the site of MC in the fibrous cap, Positive remodeling was 25% (10/41). The vessel size of proximal reference segment was smaller in MC group (p=0.09), however, lesion length (p=0.08), minimal lumen area(p=0.0002), and remodeling index (p=0.16) were similar. Although % maximal dense calcium was similar (p=0.08), however, % necrotic core was larger in MC group (p=0.05) (table). The thickness of fibrotic cap MC was correlated with %necrotc core in maximal calcium site (r=0.456, p=0.05).
Microcalcification of fibrous cap might be a cause of ACS, and helpful to identify the future cardiovascular events.