Can We Identify Unstable Coronary Plaques Before They Rupture?

Intravascular ultrasound uncovers some predictive plaque characteristics, but clinical application of the findings is still a long way off.

According to retrospective studies, many (if not most) lesions responsible for acute myocardial infarction (MI) and other acute coronary syndromes (ACS) are non–flow-limiting plaques that rupture, causing rapid progression, thrombosis, and vessel obstruction. This prospective, multicenter, industry-sponsored study included 697 patients (mean age, 58; 24% women; 17% with diabetes) who underwent successful percutaneous coronary intervention for ACS. To identify lesion-specific factors predictive of recurrent events, investigators performed both gray-scale and radiofrequency intravascular ultrasound (IVUS) of the proximal 6–8 cm of all major epicardial coronary arteries. Median follow-up was 3.4 years.

IVUS-related complications occurred in 1.6…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI