Discrimination of early/intermediate and advanced/complicated coronary plaque types by radiofrequency intravascular ultrasound analysis

Stähr, Peter; Höfflinghaus, Tobias; Voigtländer, Thomas; Courtney, Brian K.; Victor, Anja; Otto, Mike; Yock, Paul G.; Brennecke, R.; Fitzgerald, Peter J.

doi:10.1016/s0002-9149(02)02379-2

Cited by 29 publications

(16 citation statements)

References 13 publications

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“…16 Spectral analysis of IVUS radiofrequency (RF) data can provide detailed quantitative and qualitative information on coronary plaque composition in vivo. [17][18][19][20][21] Nasu et al found that in vivo characterization of coronary plaques by 'virtual histology (VH)' correlated favorably with the results of in vitro histopathological examination of tissue samples obtained by directional coronary atherectomy. 22 In this study, we used VH-IVUS to evaluate short-term quantitative and qualitative changes in non-culprit lesions in a comparison of pitavastatin, a new strong statin, with atorvastatin after administration in the early stage (2-3 weeks) after onset of ACS.…”

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confidence: 99%

Early Effect of Lipid-Lowering Therapy With Pitavastatin on Regression of Coronary Atherosclerotic Plaque Comparison With Atorvastatin

Toi

Tanaka

Yoneda

et al. 2009

Circ J

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arge-scale clinical studies have recently shown an inhibitory effect on cardiovascular events of lipidlowering therapy with HMG-CoA reductase inhibitors (statins), indicating the usefulness of this therapy. [1][2][3][4][5][6][7][8] The benefit is particularly marked in patients with coronary heart disease (CHD), and the guidelines of the American National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III positively state the utility of lipid-lowering therapy in reducing low-density lipoprotein (LDL)-cholesterol (C) to below 70 mg/dl in patients with coronary artery disease. 9 In Japan, the guidelines for prevention of arteriosclerotic diseases specify a target value of LDL-C of less than 100 mg/dl for control of CHD patients in category C. 10 Evaluation of coronary arterial plaques by imaging diagnosis has progressed markedly in recent years. In the REVERSAL study, intravascular ultrasonography (IVUS) was used to compare the effect of lipid-lowering therapy between CHD patients treated with standard and active regimens, with the latter found to inhibit expansion of coronary plaques. 11 Size reduction of coronary plaques on IVUS by statin treatment in patients with acute coronary syndrome (ACS) has also been reported in Japan (the ESTABLISH study). 12 Subsequent multicenter studies such as the JAPAN-ACS study have verified the ESTABLISH results through investigation of strong statin-induced volume reduction of coronary plaques. [13][14][15] However, these studies have all evaluated quantitative changes of the plaques, and there have been fewer qualitative evaluations. 16 Spectral analysis of IVUS radiofrequency (RF) data can provide detailed quantitative and qualitative information on coronary plaque composition in vivo. [17][18][19][20][21] Nasu et al found that in vivo characterization of coronary plaques by 'virtual histology (VH)' correlated favorably with the results of in vitro histopathological examination of tissue samples obtained by directional coronary atherectomy. 22 In this study, we used VH-IVUS to evaluate short-term quantitative and qualitative changes in non-culprit lesions in a comparison of pitavastatin, a new strong statin, with atorvastatin after administration in the early stage (2-3 weeks) after onset of ACS. The follow-up period of 2-3 weeks was chosen to evaluate the inhibition of short-term events within 1 month by early statin administration after ACS onset, and to examine if the statin effect starts to appear in this period. Methods Study Design and Patient PopulationThe study was performed as a prospective, randomized, single-center trial to assess the effect of 2-to 3-weeks of (Received November 5, 2008 Patients with acute coronary syndrome who underwent emergency percutaneous coronary intervention (PCI) were randomly assigned to receive pitavastatin (n=80; 2 mg/day) or atorvastatin (n=80; 10 mg/day) immediately after PCI. All patients underwent a blood lipid test and VH-IVUS evaluation of non-PCI lesions at admission and after 2-3 weeks of statin administration. A...

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confidence: 99%

Early Effect of Lipid-Lowering Therapy With Pitavastatin on Regression of Coronary Atherosclerotic Plaque Comparison With Atorvastatin

Toi

Tanaka

Yoneda

et al. 2009

Circ J

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“…[6][7][8][9] A preliminary in vitro study showed that 4 components (eg, fibrous, fibrofatty, dense calcium components, and necrotic core) correlated with a specific spectrum of the RF signal. 10 Nasu et al used a color-coded mapping method by Virtual Histology (VH) that was able to identify atherosclerotic plaque composition of human coronary arteries in vivo.…”

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Relationship Between Coronary Artery Remodeling and Plaque Composition in Culprit Lesions An Intravascular Ultrasound Radiofrequency Analysis

Higashikuni

Tanabe

Yamamoto

et al. 2007

Circ J

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any clinical studies have shown that coronary arteries respond to plaque growth by either outward expansion of the vessel wall (positive remodeling) 1-3 or vessel shrinkage (negative remodeling). 4,5 The difference in plaque morphology between positive and negative remodeling lesions in vivo has been investigated in several clinical studies using intravascular ultrasound (IVUS), but it is difficult to evaluate the detailed plaque composition with gray-scale IVUS.Recently, spectral analysis of IVUS radiofrequency (RF) data was shown to provide detailed quantitative and qualitative information on coronary plaque composition in vivo. [6][7][8][9] A preliminary in vitro study showed that 4 components (eg, fibrous, fibrofatty, dense calcium components, and necrotic core) correlated with a specific spectrum of the RF signal. 10 Nasu et al used a color-coded mapping method by Virtual Histology (VH) that was able to identify atherosclerotic plaque composition of human coronary arteries in vivo. 11 Previous studies using necropsy specimens or gray-scale IVUS have consistently found a large lipid burden in positive remodeling lesions, 12-14 but the role of calcium deposition in coronary artery remodeling is still controversial. 4,[13][14][15][16] In the present study, we used spectral analysis of IVUS RF data to evaluate the relationship between coronary artery remodeling and culprit plaque composition in patients undergoing percutaneous coronary intervention (PCI) in order to confirm the findings of previous studies on lipid burden and to elucidate the role of calcium deposition. Methods Patients and LesionsBetween June 2005 and January 2006, a pre-interventional IVUS examination was performed prospectively in 93 consecutive de novo culprit lesions of 81 patients undergoing PCI; 18 lesions were excluded from analyses because we could not cross the lesion completely with the IVUS transducer; the images of 6 lesions could not be analyzed because of poor image quality; and for 13 lesions, no proximal reference site could be defined because the lesion involved the ostium (n=3) or a bifurcation (n=10). Finally, IVUS RF analyses were performed for 56 culprit lesions of 52 patients.Informed, written consent was given by all the patients. DefinitionsHyperlipidemia was defined as total cholesterol level ≥220 mg/dl, high-density lipoprotein cholesterol level <40 mg/dl, triglyceride level ≥150 mg/dl, low-density lipoprotein (LDL) level ≥140 mg/dl, or/and lipid-lowering medication use. Hypertension was defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or/and use of an antihypertensive drug. Diabetes mellitus was defined by a previous physician's diagnosis and treatment with diet, oral hypoglycemic agents, or insulin.Circ J 2007; 71: 654 -660 (Received September 13, 2006; revised manuscript received January 15, 2007; accepted February 9, 2007

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“…Second, reproductive abnormalities are often part of the metabolic syndrome when it occurs in premenopausal women (Sam and Dunaif, 2003). Metabolic syndrome is recognized as a major risk factor for T2D (Reusch, 2002). Third, pregnancy losses, predominantly through stillbirth, are high in women with type 1 diabetes and T2D (Macintosh et al ., 2006).…”

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confidence: 99%

Low fertility and the risk of type 2 diabetes in women

et al. 2011

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BACKGROUNDFertility problems are frequently followed by early menopause, and early menopause has been associated with increased risk of type 2 diabetes (T2D). Thus far, it is unknown whether low fertility is independently associated with future T2D risk.METHODSWe assessed the association between measures of low fertility and T2D in the Prospect-European Prospective Investigation into Cancer and Nutrition (EPIC) cohort of 17 357 Dutch women, aged 49–70 years at baseline using Cox proportional hazards models, adjusted for various confounders. To investigate whether BMI and waist circumference influence the observed associations, analyses were additionally adjusted for these variables.RESULTSAt baseline, 332 women had T2D. During a mean follow-up of 9.1 ± 3.6 years, 535 T2D cases occurred. Out of 15 707 Prospect-EPIC women who wanted to get pregnant, 1940 consulted a physician for fertility problems and 700 remained childless. No relation was found between consulting a physician for fertility problems or nulliparity and T2D risk. Of all women who wanted to get pregnant, 3946 (25.1%) had one or more miscarriages, with an average of 1.4 (±0.9) miscarriages and a maximum of 10 miscarriages. Women who had one or more miscarriage showed the same risk for T2D as women who had no miscarriage. Also, none of the other measures of low fertility were associated with increased risk for T2D.CONCLUSIONSGenerally, measures of low fertility were not independently associated with a risk of T2D in a cohort of 17 357 Dutch women.

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Discrimination of early/intermediate and advanced/complicated coronary plaque types by radiofrequency intravascular ultrasound analysis

Cited by 29 publications

References 13 publications

Early Effect of Lipid-Lowering Therapy With Pitavastatin on Regression of Coronary Atherosclerotic Plaque Comparison With Atorvastatin

Early Effect of Lipid-Lowering Therapy With Pitavastatin on Regression of Coronary Atherosclerotic Plaque Comparison With Atorvastatin

Relationship Between Coronary Artery Remodeling and Plaque Composition in Culprit Lesions An Intravascular Ultrasound Radiofrequency Analysis

Low fertility and the risk of type 2 diabetes in women

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