Relationship between palpography and virtual histology in patients with acute coronary syndromes

Salvatore Brugaletta, Hector M. Garcia-Garcia, Patrick W. Serruys, Akiko Maehara, Vasim Farooq, Gary S. Mintz, Bernard De Bruyne, Steven P. Marso, Stefan Verheye, Dariusz Dudek, Christian W. Hamm, Nahim Farhat, Francois Schiele, John McPherson, Amir Lerman, Pedro R. Moreno, Bertil Wennerblom, Martin Fahy, Barry Templin, Marie Angel MorelGerrit Anne Van Es, Gregg W. Stone

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objectives: The purpose of this study was to correlate adverse events at long-term follow-up in patients after an acute coronary syndrome with coronary plaque characteristics derived from simultaneous evaluation of their mechanical and compositional properties using virtual histology (intravascular ultrasound virtual histology) and palpography. Background: Fibroatheroma is the plaque morphology with the highest risk of causing adverse cardiac events. Palpography can potentially assess the local mechanical plaque properties with the possibility of identifying fibroatheroma with the highest risk of rupture. Methods: A total of 114 patients with acute coronary syndrome from the PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree) trial underwent a single ultrasound imaging investigation of their 3 coronary vessels with the co-registration of intravascular ultrasound virtual histology and palpography. Major adverse cardiac events (MACE) (cardiac death, cardiac arrest, myocardial infarction, or unstable or progressive angina) were collected up to a median follow-up of 3.4 years and adjudicated to originally treated culprit versus untreated nonculprit lesions. Results: In total, 488 necrotic corerich plaques were identified and subclassified as thin-cap fibroatheroma (n = 111), calcified thick-cap fibroatheroma (n = 213), and noncalcified thick-cap fibroatheroma (n = 164) and matched to their co-registered palpography data. A total of 16 MACE, adjudicated to untreated nonculprit lesions, were recorded at follow-up. In patients in whom MACE developed, fibroatheroma were larger (plaque area 10.0 mm 2 [range: 8.4 to 11.6 mm 2] vs. 8.2 mm 2 [range: 7.7 to 8.8 mm 2] (p = 0.03) compared with patients who were MACE free. By palpography, the maximum and the density strain values did not differ between the varying subtypes of fibroatheroma of patients with or without MACE during follow-up. Conclusions: In acute coronary syndromes, patients treated with stents and contemporary pharmacotherapy, palpography did not provide additional diagnostic information for the identification of fibroatheroma with a high risk of rupture and MACE during long-term follow-up. (Providing Regional Observations to Study Predictors of Events in the Coronary Tree [PROSPECT]: An Imaging Study in Patients With Unstable Atherosclerotic Lesions; NCT00180466)

Original languageEnglish (US)
JournalJACC: Cardiovascular Imaging
Volume5
Issue number3 SUPPL.
DOIs
StatePublished - Mar 2012

Fingerprint

Atherosclerotic Plaques
Acute Coronary Syndrome
Histology
Rupture
Heart Arrest
Stents
Ultrasonography
Coronary Vessels
Myocardial Infarction
Drug Therapy

Keywords

  • intravascular ultrasound
  • palpography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Brugaletta, S., Garcia-Garcia, H. M., Serruys, P. W., Maehara, A., Farooq, V., Mintz, G. S., ... Stone, G. W. (2012). Relationship between palpography and virtual histology in patients with acute coronary syndromes. JACC: Cardiovascular Imaging, 5(3 SUPPL.). https://doi.org/10.1016/j.jcmg.2011.02.026

Relationship between palpography and virtual histology in patients with acute coronary syndromes. / Brugaletta, Salvatore; Garcia-Garcia, Hector M.; Serruys, Patrick W.; Maehara, Akiko; Farooq, Vasim; Mintz, Gary S.; De Bruyne, Bernard; Marso, Steven P.; Verheye, Stefan; Dudek, Dariusz; Hamm, Christian W.; Farhat, Nahim; Schiele, Francois; McPherson, John; Lerman, Amir; Moreno, Pedro R.; Wennerblom, Bertil; Fahy, Martin; Templin, Barry; Morel, Marie Angel; Van Es, Gerrit Anne; Stone, Gregg W.

In: JACC: Cardiovascular Imaging, Vol. 5, No. 3 SUPPL., 03.2012.

Research output: Contribution to journalArticle

Brugaletta, S, Garcia-Garcia, HM, Serruys, PW, Maehara, A, Farooq, V, Mintz, GS, De Bruyne, B, Marso, SP, Verheye, S, Dudek, D, Hamm, CW, Farhat, N, Schiele, F, McPherson, J, Lerman, A, Moreno, PR, Wennerblom, B, Fahy, M, Templin, B, Morel, MA, Van Es, GA & Stone, GW 2012, 'Relationship between palpography and virtual histology in patients with acute coronary syndromes', JACC: Cardiovascular Imaging, vol. 5, no. 3 SUPPL.. https://doi.org/10.1016/j.jcmg.2011.02.026
Brugaletta, Salvatore ; Garcia-Garcia, Hector M. ; Serruys, Patrick W. ; Maehara, Akiko ; Farooq, Vasim ; Mintz, Gary S. ; De Bruyne, Bernard ; Marso, Steven P. ; Verheye, Stefan ; Dudek, Dariusz ; Hamm, Christian W. ; Farhat, Nahim ; Schiele, Francois ; McPherson, John ; Lerman, Amir ; Moreno, Pedro R. ; Wennerblom, Bertil ; Fahy, Martin ; Templin, Barry ; Morel, Marie Angel ; Van Es, Gerrit Anne ; Stone, Gregg W. / Relationship between palpography and virtual histology in patients with acute coronary syndromes. In: JACC: Cardiovascular Imaging. 2012 ; Vol. 5, No. 3 SUPPL.
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T1 - Relationship between palpography and virtual histology in patients with acute coronary syndromes

AU - Brugaletta, Salvatore

AU - Garcia-Garcia, Hector M.

AU - Serruys, Patrick W.

AU - Maehara, Akiko

AU - Farooq, Vasim

AU - Mintz, Gary S.

AU - De Bruyne, Bernard

AU - Marso, Steven P.

AU - Verheye, Stefan

AU - Dudek, Dariusz

AU - Hamm, Christian W.

AU - Farhat, Nahim

AU - Schiele, Francois

AU - McPherson, John

AU - Lerman, Amir

AU - Moreno, Pedro R.

AU - Wennerblom, Bertil

AU - Fahy, Martin

AU - Templin, Barry

AU - Morel, Marie Angel

AU - Van Es, Gerrit Anne

AU - Stone, Gregg W.

PY - 2012/3

Y1 - 2012/3

N2 - Objectives: The purpose of this study was to correlate adverse events at long-term follow-up in patients after an acute coronary syndrome with coronary plaque characteristics derived from simultaneous evaluation of their mechanical and compositional properties using virtual histology (intravascular ultrasound virtual histology) and palpography. Background: Fibroatheroma is the plaque morphology with the highest risk of causing adverse cardiac events. Palpography can potentially assess the local mechanical plaque properties with the possibility of identifying fibroatheroma with the highest risk of rupture. Methods: A total of 114 patients with acute coronary syndrome from the PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree) trial underwent a single ultrasound imaging investigation of their 3 coronary vessels with the co-registration of intravascular ultrasound virtual histology and palpography. Major adverse cardiac events (MACE) (cardiac death, cardiac arrest, myocardial infarction, or unstable or progressive angina) were collected up to a median follow-up of 3.4 years and adjudicated to originally treated culprit versus untreated nonculprit lesions. Results: In total, 488 necrotic corerich plaques were identified and subclassified as thin-cap fibroatheroma (n = 111), calcified thick-cap fibroatheroma (n = 213), and noncalcified thick-cap fibroatheroma (n = 164) and matched to their co-registered palpography data. A total of 16 MACE, adjudicated to untreated nonculprit lesions, were recorded at follow-up. In patients in whom MACE developed, fibroatheroma were larger (plaque area 10.0 mm 2 [range: 8.4 to 11.6 mm 2] vs. 8.2 mm 2 [range: 7.7 to 8.8 mm 2] (p = 0.03) compared with patients who were MACE free. By palpography, the maximum and the density strain values did not differ between the varying subtypes of fibroatheroma of patients with or without MACE during follow-up. Conclusions: In acute coronary syndromes, patients treated with stents and contemporary pharmacotherapy, palpography did not provide additional diagnostic information for the identification of fibroatheroma with a high risk of rupture and MACE during long-term follow-up. (Providing Regional Observations to Study Predictors of Events in the Coronary Tree [PROSPECT]: An Imaging Study in Patients With Unstable Atherosclerotic Lesions; NCT00180466)

AB - Objectives: The purpose of this study was to correlate adverse events at long-term follow-up in patients after an acute coronary syndrome with coronary plaque characteristics derived from simultaneous evaluation of their mechanical and compositional properties using virtual histology (intravascular ultrasound virtual histology) and palpography. Background: Fibroatheroma is the plaque morphology with the highest risk of causing adverse cardiac events. Palpography can potentially assess the local mechanical plaque properties with the possibility of identifying fibroatheroma with the highest risk of rupture. Methods: A total of 114 patients with acute coronary syndrome from the PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree) trial underwent a single ultrasound imaging investigation of their 3 coronary vessels with the co-registration of intravascular ultrasound virtual histology and palpography. Major adverse cardiac events (MACE) (cardiac death, cardiac arrest, myocardial infarction, or unstable or progressive angina) were collected up to a median follow-up of 3.4 years and adjudicated to originally treated culprit versus untreated nonculprit lesions. Results: In total, 488 necrotic corerich plaques were identified and subclassified as thin-cap fibroatheroma (n = 111), calcified thick-cap fibroatheroma (n = 213), and noncalcified thick-cap fibroatheroma (n = 164) and matched to their co-registered palpography data. A total of 16 MACE, adjudicated to untreated nonculprit lesions, were recorded at follow-up. In patients in whom MACE developed, fibroatheroma were larger (plaque area 10.0 mm 2 [range: 8.4 to 11.6 mm 2] vs. 8.2 mm 2 [range: 7.7 to 8.8 mm 2] (p = 0.03) compared with patients who were MACE free. By palpography, the maximum and the density strain values did not differ between the varying subtypes of fibroatheroma of patients with or without MACE during follow-up. Conclusions: In acute coronary syndromes, patients treated with stents and contemporary pharmacotherapy, palpography did not provide additional diagnostic information for the identification of fibroatheroma with a high risk of rupture and MACE during long-term follow-up. (Providing Regional Observations to Study Predictors of Events in the Coronary Tree [PROSPECT]: An Imaging Study in Patients With Unstable Atherosclerotic Lesions; NCT00180466)

KW - intravascular ultrasound

KW - palpography

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