Letter to the EditorCoronary risk factors and coronary atheroma burden at severely narrowing segments
Introduction
A recent report using 3-dimensional intravascular ultrasound (IVUS) demonstrated that some established cardiovascular risk factors (male gender, hypertension and diabetes) are independent predictors of atherosclerotic burden in a native coronary artery with relatively mild angiographic narrowing (20–50% diameter stenosis (DS) by visual estimation) [1]. However, whether established cardiovascular risk factors can predict volumetric measurements of coronary atheroma burden at severely narrowing segments (> 50% DS) remains unknown.
Section snippets
Materials and methods
Patients who met the following criteria were identified from the IVUS database of the Cardiovascular Core Analysis Laboratory at Stanford University (Stanford, California): high-quality, automated pull-back IVUS images of severely narrowing segments (> 50% DS) prior to intervention. Data on cardiovascular risk factors were collected. All cineangiograms were analyzed at a central core laboratory using standardized criteria. The protocol was approved by the institutional review board, and written
Results
A total of 250 patients were enrolled in the study. Patient demographics, lesion characteristics, and IVUS variables are summarized in Table 1, Table 2, Table 3. Univariate and multivariate predictors of IVUS disease burden are summarized in Table 4. For percent plaque volume, diabetes or hypertension were predictors of more severe disease. For average plaque area, male gender or diabetes were predictors of more severe disease. These variables were also independent predictors in multivariate
Discussion
Compared to a previous report, [1] patients have more disease burden in this study (percent plaque volume, 69.3% vs. 38.9%). Although this study included older patients, more males, more smokers, more patients with diabetes, but fewer patients with hypertension or dyslipidemia, the difference may come mainly from differences of analyzed segments. Due to the study design (paired analysis between baseline and 18 month follow-up), the previous report analyzed segments with relatively mild stenosis
Acknowledgment
The authors thank Heidi N. Bonneau, RN, MS for her expert review of the manuscript.
References (10)
- et al.
Relationship between cardiovascular risk factors and atherosclerotic disease burden measured by intravascular ultrasound
J Am Coll Cardiol
(2006) - et al.
Effects of statins on vascular structure and function: a systematic review
Am J Med
(2004) - et al.
Diagnostic accuracy of optical coherence tomography and integrated backscatter intravascular ultrasound images for tissue characterization of human coronary plaques
J Am Coll Cardiol
(2006) - et al.
Serial volumetric (three-dimensional) intravascular ultrasound analysis of restenosis after directional coronary atherectomy
J Am Coll Cardiol
(1998) - et al.
Delivered dose and vascular response after beta-radiation for in-stent restenosis: retrospective dosimetry and volumetric intravascular ultrasound analysis
Circulation
(2002)
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