Coronary Plaque Vulnerability in Metabolic Syndrome  Assessment of Carotid Artery Morphology in Acute Coronary Syndrome

Kato, Masaya; Dote, Keigo; Sasaki, Shota; Ueda, Kentaro; Matsuda, Osamu; Nakano, Yoshinori; Naganuma, Toru; Sugiura, Tomohito

doi:10.1253/circj.71.1229

Cited by 14 publications

(2 citation statements)

References 25 publications

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“…Goldstein et al [8] reported that the presence of multiple complex plaques was a strong predictor of adverse cardiovascular events at 1 year. Our previous study [9] showed that the metabolic syndrome is a useful independent predictor of multiple complex coronary lesions in Japanese men with ACS. We demonstrated that abdominal obesity and low levels of high-density lipoprotein (HDL) cholesterol, but not high levels of low-density lipoprotein (LDL) cholesterol, seemed to be the key factors in predicting a greater risk of complex coronary lesions.…”

Section: Introductionmentioning

confidence: 98%

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Clinical impact of dyslipidemia for coronary plaque vulnerability in acute coronary syndrome without metabolic syndrome

Kato

Dote

Sasaki

et al. 2009

Journal of Cardiology

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Section: Introductionmentioning

confidence: 98%

“…Although the metabolic syndrome is an important predictor of risk stratification of recurrent acute coronary events in men with ACS [9], LDL cholesterol is a well-known risk factor for coronary atherosclerosis [18]. Important markers for ACS in patients without the metabolic syndrome remain unclear.…”

Section: Introductionmentioning

confidence: 99%

Clinical impact of dyslipidemia for coronary plaque vulnerability in acute coronary syndrome without metabolic syndrome

Kato

Dote

Sasaki

et al. 2009

Journal of Cardiology

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Presentations of acute coronary syndrome related to coronary lesion morphologies as assessed by intravascular ultrasound and optical coherence tomography

Kato

Dote

Sasaki

et al. 2013

International Journal of Cardiology

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Assessment of Carotid Plaque Vulnerability Using Structural and Geometrical Determinants

Tang

U-King-Im

et al. 2008

Circ J

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upture of atheromatous plaque in the carotid artery often leads to thrombosis and subsequent stroke. 1 This is potentially preventable by carotid revascularization techniques, and the degree of luminal stenosis is commonly used in clinical practice as an indicator for carotid endarterectomy or carotid artery angioplasty/stenting. Carotid endarterectomy has been shown to be beneficial in patients with symptomatic high-grade (70-99%) stenosis, 2,3 but it is more difficult to draw conclusions about possible benefits for patients with moderate carotid stenosis. Moreover, the debate continues about whether or not asymptomatic patients with a moderate stenosis should undergo endarterectomy, despite the findings of the recent Asymptomatic Carotid Surgery Trial (ACST). 4 Previous studies have shown that vulnerable plaque (ie, prone to rupture with thromboembolic complications) has a thin fibrous cap, a large lipid core and a high inflammatory cell burden. 5,6 Therefore, investigating plaque structure and morphology may aid in the risk stratification of patients with a moderate luminal stenosis.Although the original concept of vulnerable plaque was derived from the coronary circulation, there are compelling reasons why it also applies to the carotid circulation. [7][8][9][10][11][12] The mechanism of plaque rupture is not entirely clear, but is thought to be a multifactorial process involving thinning and weakening of the fibrous cap by enzymes secreted by activated macrophages, and biomechanical stress as the trigger leading to plaque rupture. [13][14][15] From the point of view of structural analysis, plaque rupture is structural failure when the plaque cannot resist the hemodynamic blood pressure and shear stress exerted on it. In the process of plaque rupture, an excessive concentration of stress at a weak site on the plaque surface is considered to be an important factor. [16][17][18] The mechanism of plaque rupture has been widely studied using computational simulations. 17,19,20 Hung et al used histology-based 2-dimensional (D) solid models for arterial plaque and found that a thin fibrous cap and a large lipid core are important determinants of increased plaque stress. 21 Cheng et al used a finite element model based on histology to analyze coronary lesions, and their data suggested that the concentration of circumferential tensile stress in the lesion may play an important role in plaque rupture and myocardial infarction. 17 Tang et al used an ex vivo magnetic resonance imaging (MRI)-based flow-structure interaction model to study the interaction between flow and plaque, and suggested that large cyclic stress -strain variations in the plaque under pulsatile flow pressure may lead to plaque fatigue and possible rupture. 22 Imoto et al used longitudinal structural analysis of plaque rupture and revealed that plaque shape, size and remodeling may be associated with plaque rupture. 23 We previously used a blood flow and plaque interaction model to demonstrate Assessment of Carotid Plaque Vulnerability Using Structu...

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Coronary Plaque Vulnerability in Metabolic Syndrome Assessment of Carotid Artery Morphology in Acute Coronary Syndrome

Cited by 14 publications

References 25 publications

Clinical impact of dyslipidemia for coronary plaque vulnerability in acute coronary syndrome without metabolic syndrome

Clinical impact of dyslipidemia for coronary plaque vulnerability in acute coronary syndrome without metabolic syndrome

Presentations of acute coronary syndrome related to coronary lesion morphologies as assessed by intravascular ultrasound and optical coherence tomography

Assessment of Carotid Plaque Vulnerability Using Structural and Geometrical Determinants

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