TY - JOUR
T1 - An intravascular ultrasound appraisal of atherosclerotic plaque distribution in diseased coronary arteries
AU - Golinvaux, Nicholas
AU - Maehara, Akiko
AU - Mintz, Gary S.
AU - Lansky, Alexandra J.
AU - McPherson, John
AU - Farhat, Naim
AU - Marso, Steven
AU - De Bruyne, Bernard
AU - Serruys, Patrick W.
AU - Templin, Barry
AU - Cheong, Wai Fung
AU - Aaskar, Rasha
AU - Fahy, Martin
AU - Mehran, Roxana
AU - Leon, Martin
AU - Stone, Gregg W.
N1 - Funding Information:
The PROSPECT study was sponsored by Abbott Vascular, Santa Clara, CA, and funded by Abbott Vascular and Volcano Corporation, San Diego, CA; however, neither Abbott nor Volcano provided extramural funding for the current analysis. Furthermore, the authors are solely responsible for the design and conduct of this study, all study analyses, the drafting and editing of the paper and its final contents.
PY - 2012/4
Y1 - 2012/4
N2 - Background: The assumption that atherosclerosis accumulates in the proximal coronary arteries and that distal segments are spared has yet to be systematically shown in vivo. Methods: We used intravascular ultrasound to analyze complete proximal, mid, and distal segments from 75 diseased left anterior descending arteries (LADs) and 61 diseased right coronary arteries (RCAs) (including either the posterolateral [PLA; n = 38] or posterior descending artery [PDA; n = 23]) to document that distal coronary arteries are more often free of disease vs proximal vessels. External elastic membrane, lumen, and plaque and media areas were measured every 0.4 mm (median), and plaque burden (plaque and media/external elastic membrane) and percentage of normal (plaque and media thickness <0.3 mm) cross sections/segment were determined. Results: Left anterior descending artery plaque was heaviest in proximal and mid segments, diminishing significantly in distal segments; plaque burden was 46% ± 9% in proximal, 39% ± 8% in mid, and 31% ± 9% in distal LAD (P <.0001), with 93% (median) of distal LAD cross sections being normal compared with 21% of mid and 0% of proximal cross sections (P <.0001). Right coronary artery plaque gradient was less pronounced vs the LAD; plaque burden was 37% ± 13% in proximal, 40% ± 10% in mid, and 36% ± 10% in distal RCA, followed by 31% ± 11% in PDA and 33% ± 10% in PLA. This was supported by the median percentage of normal cross sections/segment: 0% proximal, 0% mid, and 23% distal RCA sections plus 100% PDA and 48% PLA sections. Conclusions: Intravascular ultrasound data indicated a proximal-to-distal LAD plaque gradient; significant disease was uncommon in the distal LAD. Conversely, the proximal-to-distal RCA plaque gradient was less distinct than the LAD, although disease in the PDA was still reduced compared with proximal segments.
AB - Background: The assumption that atherosclerosis accumulates in the proximal coronary arteries and that distal segments are spared has yet to be systematically shown in vivo. Methods: We used intravascular ultrasound to analyze complete proximal, mid, and distal segments from 75 diseased left anterior descending arteries (LADs) and 61 diseased right coronary arteries (RCAs) (including either the posterolateral [PLA; n = 38] or posterior descending artery [PDA; n = 23]) to document that distal coronary arteries are more often free of disease vs proximal vessels. External elastic membrane, lumen, and plaque and media areas were measured every 0.4 mm (median), and plaque burden (plaque and media/external elastic membrane) and percentage of normal (plaque and media thickness <0.3 mm) cross sections/segment were determined. Results: Left anterior descending artery plaque was heaviest in proximal and mid segments, diminishing significantly in distal segments; plaque burden was 46% ± 9% in proximal, 39% ± 8% in mid, and 31% ± 9% in distal LAD (P <.0001), with 93% (median) of distal LAD cross sections being normal compared with 21% of mid and 0% of proximal cross sections (P <.0001). Right coronary artery plaque gradient was less pronounced vs the LAD; plaque burden was 37% ± 13% in proximal, 40% ± 10% in mid, and 36% ± 10% in distal RCA, followed by 31% ± 11% in PDA and 33% ± 10% in PLA. This was supported by the median percentage of normal cross sections/segment: 0% proximal, 0% mid, and 23% distal RCA sections plus 100% PDA and 48% PLA sections. Conclusions: Intravascular ultrasound data indicated a proximal-to-distal LAD plaque gradient; significant disease was uncommon in the distal LAD. Conversely, the proximal-to-distal RCA plaque gradient was less distinct than the LAD, although disease in the PDA was still reduced compared with proximal segments.
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U2 - 10.1016/j.ahj.2011.07.031
DO - 10.1016/j.ahj.2011.07.031
M3 - Article
C2 - 22520529
AN - SCOPUS:84860188727
SN - 0002-8703
VL - 163
SP - 624
EP - 631
JO - American heart journal
JF - American heart journal
IS - 4
ER -