A Study On The Relation Between Plaque Vulnerability In Coronary Artery And Metabolic Syndrome Through Intravascular Ultrasound

ObjectiveTo study the lesion characters of the patients with Unstable Angina Pectoris (UAP) through Intravascular Ultrasound(IVUS) .Then to compare the patients' IVUS characters who are with or without metabolic syndrome(MS), including EEM area in criminal lesion ,plaque area , vascular cavity area , plaque burden , remodeling index , remodeling direction ( positive remodeling , negative remodeling , no remodeling), lesion' nature and characters (soft or hard plaque, concentric plaque or eccentric plaque , plaque rupture or not) .So as to verify the relation between MS and vulnerable plaque in coronary artery. Through detecting serum hsCRP norm , to discuss the inflammation mechanism of MS promoting plaque vulnerability in coronary artery .Methods1. Testing 63 UAP patients with one-vessel criminal lesion before percutaneous coronary intervention (PCI) operation. These patients were divided two groups according to with or without MS . Any clinical reference material was collected.2. Undergoing selected Coronary Angiography , identifying criminal lesion according to the most narrow angiography picture in many projective body positions.3. Making use of Boston Scientific Ceivis IVUS instrument ,adopting 3.2 Fr 30 MHz Ultrasound vessel as well as practicing standard PCI vessel operation skills, then to have an IVUS test on criminal lesion and close reference section in patients, including measuring each EEM area and vascular cavity area , calculatingplaque area, and plaque burden , remodeling index , ascertaining remodeling direction , observing nature and character of lesion , distinguishing soft or hard plaque, concentric plaque or eccentric plaque and plaque rupture or not, contrasting a group with another at last. Results1. Vascular cavity area of lesion position in MS group was smaller than that in non-MS group (P=0.040), but EEM area , Plaque area, and plaque burden were larger individually than that in non-MS group (P=0.047,0.001,0.041).2. Remodeling index in MS group was higher than that in non-MS group (P=0.024). Most of the two groups were negative remodeling , the percent is 51.52 % and 70.00%. Remodeling type had a significant difference in two groups (P=0.048). Positive remodeling was more common in MS group while negative remodeling was more common in non-MS group .3. Any of soft plaque , eccentric plaque and ruptured plaque in MS group was more than that in non-MS group (P=0.026,0.034,0.031).4. hsCRP level in MS group was higher than that in non-MS group (P=0.009). Conclusion1. Plaque area in coronary artery was larger and vascular cavity was more serious in the UAP patients with MS .2. Soft plaque , eccentric plaque and ruptured plaque was more in the UAP patients with MS. Positive remodeling was more and remodeling index was higher which showed vulnerable plaque in coronary artery was more in the UAP patients with MS. That indicted MS maybe promote vulnerable plaque to come into being in coronary artery.3. That higher hsCRP level in the UAP patients with MS showed a higher inflammation level.