Author + information
- Michel Toni Corban,
- Parham Eshtehardi,
- Danny Eapen,
- Emad Rasoul–Arzrumly,
- Hatem Al Kassem,
- Pankaj Manocha,
- Aalok Patel,
- Sergey Sikora,
- Girum Mekonnen,
- Mohammad Reza Hassanyar,
- Laurence Sperling,
- Arshed Quyyumi and
- Habib Samady
Acute coronary events are thought to occur when a vulnerable plaque co–exists with circulating thrombosis–promoting factors. Fibrin degradation products (FDP) are byproducts of thrombin breakdown and thus may be an indicator of subclinical vascular thrombosis and possible plaque vulnerability. We hypothesized that elevated serum levels of FDP are associated with larger total plaque and necrotic core area, considered surrogates of plaque vulnerability.
Invasive virtual histology intravascular ultrasound (VH–IVUS) and serum FDP levels were evaluated in left coronary arteries of 67 patients with stable coronary artery disease (CAD) [72%] or stabilized acute coronary syndromes (ACS) [28%]. Plaque cross–sectional area, plaque burden, and plaque composition (necrotic core, dense calcium, fibro–fatty, and fibrous tissue) were assessed in each VH–IVUS frame, and were averaged over the length of the studied vessel. FDP levels were measured at the time of IVUS study using ELISA technique. The relationship between FDP levels and plaque characteristics were investigated using univariate and multivariate analysis.
Mean age was 56±12, 52% were men, and 27% had diabetes. We observed a significant positive correlation between FDP and both plaque area (r=0.35, p=0.004) and plaque burden (r=0.25, p=0.04). In addition, we observed a significant positive correlation between FDP and both necrotic core (r=0.33, p=0.006) and fibro–fatty areas (r=0.26, p=0.04), while there was no correlation between FDP and fibrous (r=0.001, p=0.99) or dense calcium areas (r=0.04, p=0.77). In a multivariate regression analysis, after adjustment for age, sex, tobacco abuse, hypertension, diabetes, body mass index, dyslipidemia and ACS, age (p=0.031), male sex (p=0.006), ACS (p=0.036) and serum FDP levels (p=0.013) were independent predictors of larger necrotic core area. A doubling in serum FDP level was associated with a 0.38 mm2increase in necrotic core area.
In patients with CAD, higher serum levels of FDP are independently associated with larger plaques and greater plaque necrotic core and fibro–fatty components, features suggestive of increased plaque vulnerability.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.–10:30 a.m.
Session Title: Intravascular Imaging: IVUS and OCT
Abstract Category: 38. TCT@ACC–i2: Intravascular Imaging and Physiology
Presentation Number: 2108–243
- 2013 American College of Cardiology Foundation