Do systemic risk factors impact invasive findings from virtual histology? Insights from the international virtual histology registry

Sebastian Philipp, Dirk Böse, William Wijns, Steven P. Marso, Robert S. Schwartz, Andreas König, Amir Lerman, Hector M. Garcia-Garcia, Patrick W. Serruys, Raimund Erbel

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

AimsCardiovascular risk factors such as elevated serum lipid levels are important in the development of coronary atherosclerosis. Radiofrequency (RF) analysis of intravascular ultrasound [IVUS, Virtual histology™ (VH)] offers a unique tool to study the composition of coronary atherosclerotic plaque in vivo. We used data from the multicentre VH registry to assess the association between cardiovascular risk factors and coronary plaque volume and composition.Methods and resultsBetween August 2004 and July 2006, 990 patients in 42 centres were enrolled in a prospective, multicentre, non-randomized global VH registry. Coronary artery imaging was performed by conventional IVUS and RF-IVUS. The four RF-IVUS plaque components [dense calcium (DC), necrotic core (NC), fibrous (F) tissue, and fibro fatty (FF)] were analysed in every recorded frame. The results were expressed as mean cross-sectional areas, absolute volume, and percentage of total plaque volume. Risk factor assessment included evaluation of family history of previous myocardial infarction (MI), past or current smoking, diabetes mellitus, hypertension, and the laboratory measurements. Patients with diabetes had an increased relative proportion of NC (6.47 ± 0.28 vs. 5.86 ± 0.14, P = 0.037) and DC (4.58 ± 0.27 vs. 3.90 ± 0.14, P = 0.017), and patients with hypertension had an increased relative proportion of FF, DC (4.35 ± 0.16 vs. 3.57 ± 0.17, P = 0.02) and NC (6.24 ± 0.17 vs. 5.60 ± 0.19, P = 0.01). Compared with patients with LDL-C <100 mg/dL, patients with LDL-C >160 mg/dL had higher plaque volume (342.1 ± 26.2 vs. 318.6 ± 10.7 mm3). Linear regression analysis showed a correlation between the level of HDL-C and F (r =-0.149, P < 0.01), FF (r =-0.106, P < 0.01), and NC (r =-0.90, P < 0.05). The level of LDL correlated with F (r = 0.110, P < 0.01). Patients with prior MI have an increased percentage of F (30.03 ± 0.59 vs. 28.20 ± 0.37, P = 0.009). Smoking had no relevant effect on plaque composition. Treatment with acetylsalicylacid and statins reduced FF with altering plaque volume.ConclusionRadiofrequency-IVUS detects marked differences in coronary plaque composition related to the risk factor profile with particular focus on lipid levels. Greater amounts of NC were associated with diabetes, hypertension, MI, and low HDL-C. The effects of treatment of changes related to plaque composition are underway.

Original languageEnglish (US)
Pages (from-to)196-202
Number of pages7
JournalEuropean Heart Journal
Volume31
Issue number2
DOIs
StatePublished - Jan 2010

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Registries
Histology
Myocardial Infarction
Hypertension
Calcium
Smoking
Lipids
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Atherosclerotic Plaques
Adipose Tissue
Coronary Artery Disease
Linear Models
Coronary Vessels
Diabetes Mellitus
Regression Analysis
Therapeutics
Serum
oxidized low density lipoprotein

Keywords

  • Intravascular ultrasound
  • Plaque composition
  • Radiofrequency
  • Risk factors
  • Virtual histology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Do systemic risk factors impact invasive findings from virtual histology? Insights from the international virtual histology registry. / Philipp, Sebastian; Böse, Dirk; Wijns, William; Marso, Steven P.; Schwartz, Robert S.; König, Andreas; Lerman, Amir; Garcia-Garcia, Hector M.; Serruys, Patrick W.; Erbel, Raimund.

In: European Heart Journal, Vol. 31, No. 2, 01.2010, p. 196-202.

Research output: Contribution to journalArticle

Philipp, S, Böse, D, Wijns, W, Marso, SP, Schwartz, RS, König, A, Lerman, A, Garcia-Garcia, HM, Serruys, PW & Erbel, R 2010, 'Do systemic risk factors impact invasive findings from virtual histology? Insights from the international virtual histology registry', European Heart Journal, vol. 31, no. 2, pp. 196-202. https://doi.org/10.1093/eurheartj/ehp428
Philipp, Sebastian ; Böse, Dirk ; Wijns, William ; Marso, Steven P. ; Schwartz, Robert S. ; König, Andreas ; Lerman, Amir ; Garcia-Garcia, Hector M. ; Serruys, Patrick W. ; Erbel, Raimund. / Do systemic risk factors impact invasive findings from virtual histology? Insights from the international virtual histology registry. In: European Heart Journal. 2010 ; Vol. 31, No. 2. pp. 196-202.
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AU - Philipp, Sebastian

AU - Böse, Dirk

AU - Wijns, William

AU - Marso, Steven P.

AU - Schwartz, Robert S.

AU - König, Andreas

AU - Lerman, Amir

AU - Garcia-Garcia, Hector M.

AU - Serruys, Patrick W.

AU - Erbel, Raimund

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N2 - AimsCardiovascular risk factors such as elevated serum lipid levels are important in the development of coronary atherosclerosis. Radiofrequency (RF) analysis of intravascular ultrasound [IVUS, Virtual histology™ (VH)] offers a unique tool to study the composition of coronary atherosclerotic plaque in vivo. We used data from the multicentre VH registry to assess the association between cardiovascular risk factors and coronary plaque volume and composition.Methods and resultsBetween August 2004 and July 2006, 990 patients in 42 centres were enrolled in a prospective, multicentre, non-randomized global VH registry. Coronary artery imaging was performed by conventional IVUS and RF-IVUS. The four RF-IVUS plaque components [dense calcium (DC), necrotic core (NC), fibrous (F) tissue, and fibro fatty (FF)] were analysed in every recorded frame. The results were expressed as mean cross-sectional areas, absolute volume, and percentage of total plaque volume. Risk factor assessment included evaluation of family history of previous myocardial infarction (MI), past or current smoking, diabetes mellitus, hypertension, and the laboratory measurements. Patients with diabetes had an increased relative proportion of NC (6.47 ± 0.28 vs. 5.86 ± 0.14, P = 0.037) and DC (4.58 ± 0.27 vs. 3.90 ± 0.14, P = 0.017), and patients with hypertension had an increased relative proportion of FF, DC (4.35 ± 0.16 vs. 3.57 ± 0.17, P = 0.02) and NC (6.24 ± 0.17 vs. 5.60 ± 0.19, P = 0.01). Compared with patients with LDL-C <100 mg/dL, patients with LDL-C >160 mg/dL had higher plaque volume (342.1 ± 26.2 vs. 318.6 ± 10.7 mm3). Linear regression analysis showed a correlation between the level of HDL-C and F (r =-0.149, P < 0.01), FF (r =-0.106, P < 0.01), and NC (r =-0.90, P < 0.05). The level of LDL correlated with F (r = 0.110, P < 0.01). Patients with prior MI have an increased percentage of F (30.03 ± 0.59 vs. 28.20 ± 0.37, P = 0.009). Smoking had no relevant effect on plaque composition. Treatment with acetylsalicylacid and statins reduced FF with altering plaque volume.ConclusionRadiofrequency-IVUS detects marked differences in coronary plaque composition related to the risk factor profile with particular focus on lipid levels. Greater amounts of NC were associated with diabetes, hypertension, MI, and low HDL-C. The effects of treatment of changes related to plaque composition are underway.

AB - AimsCardiovascular risk factors such as elevated serum lipid levels are important in the development of coronary atherosclerosis. Radiofrequency (RF) analysis of intravascular ultrasound [IVUS, Virtual histology™ (VH)] offers a unique tool to study the composition of coronary atherosclerotic plaque in vivo. We used data from the multicentre VH registry to assess the association between cardiovascular risk factors and coronary plaque volume and composition.Methods and resultsBetween August 2004 and July 2006, 990 patients in 42 centres were enrolled in a prospective, multicentre, non-randomized global VH registry. Coronary artery imaging was performed by conventional IVUS and RF-IVUS. The four RF-IVUS plaque components [dense calcium (DC), necrotic core (NC), fibrous (F) tissue, and fibro fatty (FF)] were analysed in every recorded frame. The results were expressed as mean cross-sectional areas, absolute volume, and percentage of total plaque volume. Risk factor assessment included evaluation of family history of previous myocardial infarction (MI), past or current smoking, diabetes mellitus, hypertension, and the laboratory measurements. Patients with diabetes had an increased relative proportion of NC (6.47 ± 0.28 vs. 5.86 ± 0.14, P = 0.037) and DC (4.58 ± 0.27 vs. 3.90 ± 0.14, P = 0.017), and patients with hypertension had an increased relative proportion of FF, DC (4.35 ± 0.16 vs. 3.57 ± 0.17, P = 0.02) and NC (6.24 ± 0.17 vs. 5.60 ± 0.19, P = 0.01). Compared with patients with LDL-C <100 mg/dL, patients with LDL-C >160 mg/dL had higher plaque volume (342.1 ± 26.2 vs. 318.6 ± 10.7 mm3). Linear regression analysis showed a correlation between the level of HDL-C and F (r =-0.149, P < 0.01), FF (r =-0.106, P < 0.01), and NC (r =-0.90, P < 0.05). The level of LDL correlated with F (r = 0.110, P < 0.01). Patients with prior MI have an increased percentage of F (30.03 ± 0.59 vs. 28.20 ± 0.37, P = 0.009). Smoking had no relevant effect on plaque composition. Treatment with acetylsalicylacid and statins reduced FF with altering plaque volume.ConclusionRadiofrequency-IVUS detects marked differences in coronary plaque composition related to the risk factor profile with particular focus on lipid levels. Greater amounts of NC were associated with diabetes, hypertension, MI, and low HDL-C. The effects of treatment of changes related to plaque composition are underway.

KW - Intravascular ultrasound

KW - Plaque composition

KW - Radiofrequency

KW - Risk factors

KW - Virtual histology

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