Relationship Between Acute Coronary Syndrome And Calcification Plaque Assessed By Intravascular Ultrasound Imaging

Objective: Studies have shown that various atherosclerotic plaques contain calcific deposits, observering calcification patterns of culprit lesions in patients with acute coronary syndromes (ACS) by intravascular ultrasound (TVUS) would reveal therelationship between calcification plaque and ACS. Methods: IVUS images of 19 patients with ACS, and of 12 patients with stable angina pectoris (SAP) were studied. IVUS analysis included qualitative assessment and quantitative measurements of the calcification plaque, the average number and arc of calcium deposits, the location of calcium deposits , the remodeling index (RI) and the eccentricity index(EI) .Results: The frequency of calcium deposits within an arc of less than 90° for allcalcium deposits was significantly different in culprit lesions of patients between ACS and SAP (P≤0.0001). Moreover, the average number of calcium deposits within an arc of <90° per patient was significantly higher in ACS than in SAP (P<0.005; ACS1.4±1.3, SAP 0.5±0.8). In ACS patients, the typical pattern was spotty calcification, associated with a soft plaque and positive remodeling. Conversely, SAPpatients had the higher frequency of extensive calcification. Conclusions: Our observations show that IVUS can identify the vulnerable plaques in coronary arteries by patterns of calcification.