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ȣ - 550683 336 |
| Relation between metabolic syndrome and plaque components in patients with coronary artery disease: virtual histology-intravascular ultrasound analysis |
| 성가롤로병원 순환기내과¹ , 전남대학교병원 순환기내과² |
| 최윤하² , 조장현¹ , 김수현¹ , 최승¹ , 윤명호¹ , 박재영¹ , 홍영준² ,정명호² 김동한² 이기홍² , Futoshi Yamanaka², 이민구² , 박근호² ,심두선² , 윤남식² ,윤현주² ,김계훈² ,박형욱² ,김주한² ,안영근² ,조정관² ,박종춘² ,강정채² |
Background: Metabolic syndrome (MS) has prognostic value for atherosclerotic coronary artery disease (CAD) and presented a cluster of all the risk factors of cardiovascular diseases. The virtual histology-intravascular ultrasound (VH-IVUS) findings which are associated with MS were not well known. So we used VH-IVUS to evaluate the relation between MS and plaque components in 354 patients with CAD.
Methods: MS was defined according to modified ATP III definition and we compared VH-IVUS findings between MS group (183 patients) and non-MS group (171 patients). VH-IVUS classified the color-coded tissue into four major components: fibrotic (FT); fibro-fatty (FF); dense calcium (DC); and necrotic core (NC).
Results: MS group was significantly older, and has higher triglyceride (132±82 mg/dl vs. 86±54 mg/dl, p<0.001), and has lower high-density lipoprotein cholesterol (46±10 mg/dl vs. 51±12 mg/dl, p<0.001) compared with non-MS group. At the minimum lumen site, MS group had smaller absolute and relative FT area compared with non-MS group (3.6±2.0 mm2 vs. 4.4±3.1 mm2, p=0.007, and 52.5±15.4% vs. 56.6±14.7%, p=0.011, respectively). MS group had greater absolute and relative DC area compared with non-MS group. (0.9±0.7 mm2 vs. 0.7±0.6 mm2, p=0.024, and 14.2±11.1% vs. 11.5±9.4%, p=0.017, respectively). At the largest NC site, MS group had smaller absolute and relative FT area compared with non-MS group (3.4±1.8 mm2 vs. 4.1±2.4 mm2, p=0.006, and 45.8±13.5% vs. 50.5±14.0%, p=0.001, respectively). MS group had greater absolute and relative DC area compared with non-MS group (1.2±0.8 mm2 vs. 0.9±0.7 mm2, p=0.001, and 17.1±10.1% vs. 13.2±9.1%, p<0.001, respectively). By volumetric analysis, the relative FT volume was smaller and the relative DC volume was greater in MS group compared with non-MS group (54.8±11.1% vs. 58±11.1%, p=0.006, and 13.7±7.6% vs. 11.5±7.1%, p=0.007, respectively).
Conclusions: VH-IVUS analysis demonstrated that MS patients have smaller FT components and greater DC components compared with non-MS patients and the difference in plaque components may contribute the different clinical outcomes between MS and non-MS patients.
Key Words: metabolic syndrome, Plaque, Intravascular Ultrasound
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