In vivo virtual histology intravascular ultrasound correlates of risk factors for sudden coronary death in men: results from the prospective, multi-centre virtual histology intravascular ultrasound registry

Abstract

The ratio of NC to calcification detected by VH-IVUS in diseased coronary segments is related to known risk factors for SCD and, thus, may be associated with a worse prognosis.

Leukocyte Telomere Length Is Associated With High-Risk Plaques on Virtual Histology Intravascular Ultrasound and Increased Proinflammatory Activity

“…In recent studies, VHTCFA have been shown to be prospectively associated with multiple adverse cardiovascular events, demonstrating that VH-IVUS can identify high-risk plaques. 19,26 Similarly, culprit vessel necrotic core volume and worst necrotic core area frame plaque area were associated with shorter LTL, reinforcing previous studies linking necrotic core parameters to conventional cardiovascular risk factors, 27 and high-risk features in acute coronary syndrome. 27 To determine how short LTL could be associated with vulnerable plaques, we examined the cytokine secretion from monocytes and lymphocytes.…”

“…19,26 Similarly, culprit vessel necrotic core volume and worst necrotic core area frame plaque area were associated with shorter LTL, reinforcing previous studies linking necrotic core parameters to conventional cardiovascular risk factors, 27 and high-risk features in acute coronary syndrome. 27 To determine how short LTL could be associated with vulnerable plaques, we examined the cytokine secretion from monocytes and lymphocytes. Monocytes from CAD patients showed reduced TL length, increased ROS generation, and increased proinflammatory cytokine secretion (MCP-1, IL-6, IL-1, tumor necrosis factor-␣) vs controls.…”

Histopathological validation of optical frequency domain imaging to quantify various types of coronary calcifications

“…The presence of calcified plaques was previously thought to be merely an indicator of stable and quiescent atheroma. 2 However, coronary microcalcification can be identified in both the early and advanced stages of atherosclerosis. 12 Recent IVUS studies reported that spotty calcification is more frequently observed in the culprit lesions of patients with acute coronary syndrome.…”

More Progression Toward Regression?

“…Although plaques that rupture and cause an acute event are almost always large (8,9), specific plaque characteristics may have greater predictive value. Recent evidence from studies using VH-IVUS shows that characteristics of plaque are related to the major risk factors diabetes, hypertension, and serum LDL-C and HDL-C levels (10), and that the ratio of necrotic core to dense calcium seems to correlate with LDL-C and the total cholesterol/HDL-C ratio (11). In patients with stable angina pectoris, serial coronary VH-IVUS studies after statin therapy showed that total plaque volume and fibrofatty plaque volume decreased, and fibrous plaque volume increased (12).…”