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KMID : 0390619980060010076
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Journal of Cardiovascular Ultrasound
1998 Volume.6 No. 1 p.76 ~ p.81
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Plaque Morphology in Acute Coronary Syndrome : An Intravascular Ultrasound Study
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Choi Dae-Hyun
Kim Moo-Hyun
Cha Kwang-Soo
Kim Hyeong-Kweon
Kim Young-Dae
Kim Jong-Seong
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Abstract
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Background : Plaque ruture of the atherosclerotic plaque is an important pathophysiologic mechanism of acute coronary syndrome(acute myocardial infarction or unstable angina). Plaque repture and resulting thrombus formation could be identified by intravascular ultrasound(IVUS), even thought the sensitivity was variable in previous reports. We sought to know the morphologic characteristics, incidence of plaque repture and thrombus formation by ultrasound in patients with acute coronary syndrome.
Method : Between April and September 1997, 23 admitted patients who was diagnose as unstable angina or acute myocardial infarction was included. We performed coronary angiography with IVUS examination within 2 weeks. Atherosclerotic plaque was classified into soft, fibrous, calcific, and mixed plaque, and plaque rupture was defined as rupture of fibrous cap with discontinuity and / or backflow into plaque. Thrombus was defined as a scintillating, movable mass or layering materials that could be distinguished from underlying plaque.
Results : Most of the plaques were soft and mixed types(14 and 6, out of 23 cases). Plaque rupture could be identified only in small portion(6 cases, 26%) of the cases. Thrombus was noted in 12 cases(52%). 4 cases showed both plaque rupture and thrombus.
Conclusion : Soft plaque is the most frequent plaque type in acute coronary shyndrome. IVUS is a useful tool to identify the morphologic features of the plaque such as rupture and thrombus formation.
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KEYWORD
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Acute coronary syndrome, Plaque rupture, Thrombus
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