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TCFA的患病率和特点以及冠状动脉狭窄的程度:一项光学相干断层成像、血管内超声及冠状动脉造影研究

Prevalence and characteristics of TCFA and degree of coronary artery stenosis: An OCT, IVUS, and angiographic study

来源:Scopus 发布时间:2014-9-17
作者:Tian, J. | Dauerman, H. | Toma, C. | Samady, H. | Itoh, T. | Kuramitsu, S. | Domei, T. | Jia, H. | Vergallo, R. | Soeda, T. | Hu, S. | Minami, Y. | Lee, H. | Yu, B. | Jang, I.-K.
机构: 哈尔滨医科大学附属第二医院心血管内科
期刊: J AM COLL CARDIOL 2014年8月7期64卷

Background The relationship between features of vulnerable plaque and angiographic coronary stenosis is unknown. Objectives The purpose of this study was to systematically investigate the absolute number, relative prevalence, and characteristics of thin-cap fibroatheroma (TCFA) at different degrees of stenosis using optical coherence tomography (OCT), intravascular ultrasound, and coronary angiography. Methods We identified 643 plaques from 255 subjects who underwent OCT imaging in all 3 coronary arteries. They were divided into 3 groups on the basis of angiographic diameter stenosis: Group A (30% to 49%, n = 325), Group B (50% to 69%, n = 227), and Group C (>70%, n = 91). Results OCT showed that the absolute number of TCFA was greatest in Group A (n = 58), followed by Groups B (n = 40) and C (n = 33). However, the relative prevalence of TCFA was higher in Group C (36%) than in Groups A (18%) or B (18%) (p = 0.003 and p = 0.002, respectively). Fibrous cap of TCFA was thinner in Group C than in Groups A (p < 0.001) or B (p = 0.001). intravascular ultrasound showed that the plaque burden of TCFA was largest in Group C (80.1 ± 7.4%), compared with Groups B (67.5 ± 9.4%) and A (58.1 ± 8.4%). TCFA in Group C had a higher remodeling index than those in Group A (p = 0.002). Conclusions The absolute number of TCFA is 3 times greater in nonsevere stenosis than in severe stenosis. It is, however, twice as likely for a lesion to be TCFA in cases of severe stenosis than in nonsevere stenosis. Moreover, TCFA in severely-stenotic areas had more features of plaque vulnerability. © 2014 by the American College of Cardiology Foundation.
 

通讯作者:Department of Cardiology, 2nd Affiliated Hospital of Harbin Medical University, Chinese Ministry of Education, Harbin, China
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