PMID- 21543974
OWN - NLM
STAT- MEDLINE
DCOM- 20111108
LR  - 20110707
IS  - 1473-5830 (Electronic)
IS  - 0954-6928 (Linking)
VI  - 22
IP  - 5
DP  - 2011 Aug
TI  - Ruptured versus stable plaques in human coronary arteries.
PG  - 345-51
LID - 10.1097/MCA.0b013e3283471f95 [doi]
AB  - OBJECTIVE: To derive a model for the identification of left anterior descending 
      (LAD) coronary artery stenoses predisposed to plaque rupture and thrombosis. 
      METHODS: Coronary angiograms of 186 consecutive patients (original sample) with 
      an anterior ST elevation myocardial infarction (STEMI) and a recanalized LAD were 
      reconstructed in the three-dimensional space. Culprit lesions were compared with 
      293 stable LAD coronary stenoses on the same patients. A model for predicting 
      stenoses with a high probability of thrombosis was derived and validated in 50 
      subsequent patients with STEMI, and 50 patients with stable lesions (validation 
      sample). RESULTS: The majority of culprit lesions occurred between 20 and 40 mm 
      from the LAD ostium, whereas the majority of stable lesions were found in a 
      distance of more than 60 mm (P<0.001). Culprit lesions were statistically 
      significantly longer than stable ones (23.2 +/- 10.4 mm vs. 14.7 +/- 7.2 mm; 
      P<0.001). Bifurcations on culprit lesions were significantly more frequent 
      (86.6%) compared with stable lesions (41.3%, P<0.001). Lesion angulation was 
      significantly sharper in culprit lesions, which were symmetrical whereas stable 
      lesions resided in the inner vessel wall in respect to the local vessel 
      curvature. A simple additive tool was developed by using these parameters in a 
      multiple regression model. The discriminating ability of the proposed index was 
      high in both the original [area under the receiver operating characteristic 
      curve: 0.88 (95% confidence interval: 0.85-0.91)] and validation sample [area 
      under the receiver operating characteristic curve: 0.69 (95% confidence interval: 
      0.59-0.78)]. CONCLUSION: Specific anatomic characteristics of LAD segments 
      associated with STEMI can be identified on coronary angiograms and assist the 
      risk stratification of coronary stenoses.
FAU - Katritsis, Demosthenes G
AU  - Katritsis DG
AD  - Department of Cardiology, Athens Euroclinic, Athens, Greece. 
      dkatritsis@euroclinic.gr
FAU - Efstathopoulos, Efstathios P
AU  - Efstathopoulos EP
FAU - Pantos, Ioannis
AU  - Pantos I
FAU - Tzanalaridou, Efthalia
AU  - Tzanalaridou E
FAU - De Waha, Antoinette
AU  - De Waha A
FAU - Siontis, George C M
AU  - Siontis GC
FAU - Toutouzas, Konstantinos
AU  - Toutouzas K
FAU - Redwood, Simon
AU  - Redwood S
FAU - Kastrati, Adnan
AU  - Kastrati A
FAU - Stefanadis, Christodoulos
AU  - Stefanadis C
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Coron Artery Dis
JT  - Coronary artery disease
JID - 9011445
SB  - IM
MH  - Aged
MH  - Coronary Angiography
MH  - Coronary Stenosis/complications/*diagnosis/pathology
MH  - Coronary Thrombosis/complications/*pathology
MH  - Coronary Vessels/*pathology
MH  - Female
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/complications/*pathology
MH  - Plaque, Atherosclerotic/complications/*pathology
MH  - Rupture, Spontaneous/complications/pathology
EDAT- 2011/05/06 06:00
MHDA- 2011/11/09 06:00
CRDT- 2011/05/06 06:00
PHST- 2011/05/06 06:00 [entrez]
PHST- 2011/05/06 06:00 [pubmed]
PHST- 2011/11/09 06:00 [medline]
AID - 10.1097/MCA.0b013e3283471f95 [doi]
PST - ppublish
SO  - Coron Artery Dis. 2011 Aug;22(5):345-51. doi: 10.1097/MCA.0b013e3283471f95.