High Yellow Color Intensity by Angioscopy With Quantitative Colorimetry to Identify High-Risk Features in Culprit Lesions of Patients With Acute Coronary Syndromes

Malondialdehyde-Modified Low-Density Lipoprotein Is a Useful Marker to Identify Patients With Vulnerable Plaque

“…10 Angioscopy of ex vivo human tissue samples has indicated that a plaque with highly intense yellow color (b* >23) contained atheroma that had a fibrous cap thickness <100 μm, 10 and the clinical relevance of this parameter has been suggested by use of the quantitative colorimetry system during angioscopy. 11- 13 Highly intense yellow plaque (HIYP) with b* >23 has been demonstrated to be strongly associated with disruption and/or coronary thrombosis in ACS patients, 11 and with thin-cap fibroatheroma diagnosed on virtual histology intravascular ultrasound. 13 In the present study, therefore, we investigated the relationship between circulating MDA-LDL and angioscopic plaque characteristics with quantitative colorimetry to verify the hypothesis that elevated serum MDA-LDL reflects plaque instability in patients with CAD.…”

What Does the Yellow Color of Angioscopy Mean? Why Yellow Plaque Is Always Vulnerable?

“…In their system, a yellow color intensity and brightness can be represented as simply the b * value (yellow color intensity 0 to 100) and L * value (brightness of the color -100 to 100). Their system can consistently measure yellow plaque color independent of such conditions as light intensity, the distance from the lens of angioscope to the objective, and the angle of the angioscope to the region of interest, after proper adjustments for brightness (L * value is within 42) and are strongly correlated with the thin cap fibroatheroma determined by Virtual Histology-IVUS. 43) The plaques of b * value >23 are associated with elevated malondialdehyde-modified low-density lipoprotein levels 44) , which has been reported to be detected in the plasma of patients with ACS.…”

Multiple Yellow Plaques Assessed by Angioscopy With Quantitative Colorimetry in Patients With Myocardial Infarction

“…23 Our previous study also indicated that angioscopic yellow plaques are likely to have insufficient specificity for lipid cores underneath thin fibrous caps, 10 which is consistent with the results of the present study, and with our previous report that, in our analysis of culprit lesions in patients with acute coronary syndromes, there is an association of HYCI regions with thrombus or disruption. 24 Because of the diffuse nature of atherosclerosis, multiple coronary lipid cores underneath thin fibrous caps may manifest over time, indicated by multiple complex lesions detected during angiography 25 or by multiple ruptured plaques found during intravascular ultrasound. [26][27][28][29] However, the finding of HYCI regions implies that a number of lipid core regions underneath thin fibrous caps may not always manifest "simultaneously" on the surface of the coronary arteries of patients with MI.…”