Analysis Of Intravascular Ultrasound Imaging Of Coronary Plaque In 120 Patients With Coronary Artery Disease

Objective:Intravascular ultrasound(IVUS)was used to analyze the characteristics of coronary artery lesions in patients with Acute coronary syndrome(ACS),to identify vulnerable plaques in the coronary artery(Vulnerable plaque),and to further guide the treatment of ACS patients.Methods:A total of 120 patients diagnosed as ACS and Stable angina pectoris(SAP)were retrospectively selected from October 2017 to December 2018 in the Department of Cardiology of the Second People's Hospital of Yunnan Province.The patients were divided into ACS group and SAP group.The IVUS examination was performed in both groups to analyze the nature of coronary atherosclerotic plaques in the two groups and to compare the number of vulnerable plaques,plaque ruptures,and thrombosis.The minimum lumen area at the lesion,the plaque area,the cross-sectional area of the external elastic membrane,the cross-sectional area of the outer elastic membrane of the reference vessel segment,the plaque loading rate at the lesion and the reconstruction index were calculated.The stent was placed under the guidance of IVUS,and the number of stent placement,stent placement rate,slow coronary flow or no coronary reflow,perioperative arrhythmia,and recurrence of myocardial infarction were compared.Results:1.There were 120 patients in the two groups,60 in the ACS group and the SAP group.The nature of coronary plaques in the two groups was analyzed.It was found that 38 patients(63.3%)had soft plaques in the ACS group and soft plaques in the SAP group.There were 9 cases(15%),and the two were statistically different X2=29.41,P<0.001).The incidence of vulnerable plaque was higher in the ACS group than in the SAP group(X2=20.31,P<0.001).Patients in the ACS group were more likely to have plaque rupture(X2=5.57,P=0.018).Thrombus formation occurred in 13 patients(21.7%)with ACS,and thrombosis occurred in only 2 patients(3.3%)in the SAP group,with a statistically significant difference(X2=9.22,P=0.002).2.The EEM area of the ACS group was(13.01±3.84)mm2,the minimum lumen area(3.22±0.85)mm2,the plaque area(9.68±3.24)mm2,and the plaque load(74.53+5.83)%,compared with the SAP group.There was no statistical difference,but the remodeling index(RI=1.14 ± 0.14)was significantly greater in the ACS group than in the SAP group(RI=0.84±0.14),and both were statistically significant(P<0.001).3.The incidence of slow coronary flow or no coronary reflow after stent placement was significantly higher in the ACS group than in the SAP group(X2=15.36,P<0.001).In terms of per capita hospitalization expenses,the ACS group was higher than the SAP group.There were no significant differences in the number of stent placements,stent compliance rates,perioperative arrhythmias,and recurrent myocardial infarction between the two groups.Conclusions:1.ACS and SAP patients have different imaging features in IVUS examination.The lesions in ACS patients are mainly soft spots.Vulnerable plaques,plaque rupture and thrombosis are more common in SAP patients,and the remodeling index is significantly higher than that in SAP group.2.IVUS has a high value in evaluating the nature,morphology,stability and degree of coronary stenosis.3.The IVUS examination showed that patients with ACS had a higher probability of slow coronary flow or no coronary reflow after stent placement than the SAP group.