Virtual histology of coronary arteries using intravascular ultrasound (IVUS) - local experience.

Abstract

Background: In the occurrence of coronary events, atherosclerotic plaque characteristics have been demonstrated to play a pivotal role. Based on histological studies of victims of sudden cardiac death, lesions containing a large amount of necrotic core with an overlying thin fibrous cap (referred to as thin cap fibroatheroma TCFA) have been linked to plaque rupture. In vivo detection of potentially vulnerable plaques may improve the prevention of cardiovascular events.

The aim of the study was to find out the pattern of plaque morphology using VH-IVUs in our population.

Methodology: This descriptive study was conducted in Lady Reading Hospital, Peshawar. We enrolled patients with a history of coronary artery disease admitted for coronary angiography from 2007 to 2011. Virtual histology was obtained for the fibrofatty, fibrous, calcified, and necrotic plaques. The sizes of the vessels and lumen were measured. The results of the study were mentioned in mean, standard deviation, and percentage of different variables.

Results: A total of 41 patients were studied.  The mean age was 56.3 years (+ 9.9 SD). Males were 29 (70.7%). Chest pain was almost reported by all patients (100%). Acute coronary syndrome (ACS) diagnosis was present in 23 patients (56.1%), while patients with chronic coronary syndrome (CCS) were 18 (43.9%). The Minimum plaque burden was 58.5%, while the maximum was 89.6%, with a mean value of 73.1%. The most common plaque type was fibrous (77.3% SD +6.4), followed by fibro¬fatty plaque (13.02% SD +3.5). The necrotic type was 7.09 % SD +6.2, while calcified plaque was 2.2% SD + 1.4.

Conclusion: Fibrous type plaque was the most common type of VH IVUS in both CCS patients and the ACS group; However, necrotic core was comparatively more in the ACS group.