الفهرس 
Management of intermediate coronary lesion in acute coronary syndrome
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Abstract
Twenty eight patients with the diagnosis of Non ST Elevation Acute Coronary Syndromes. Coronary Angiography showed intermediate lesions assessed by QCA and IVUS. Percent area stenosis {u2265} 70%, MLA adjusted to the reference vessel diameter & MLA {u2264} 6mm2 for left main artery were the criteria for intervention. Three to six months clinical follow up regarding MACE and six months mortality.Results : Mean age was 53.2 ± 9.1 years. Males=20 (71.4%). Smoking in 17 (60.7%), hypertension in 16 (57.1%), Dyslipidemia in 12 (42.9%) & DM in 8 (28.6%). Mean BMI=23.4 ± 2.9. Twenty three patients diagnosed as UA and five patients diagnosed as NSTEMI. Mean TIMI risk score 3.1±1.4. A statistically significant higher TIMI risk score in NSTEMI group (P=0.02). Multi-vessel disease in 17 patients (60.8%). Seventy six vessels were affected with 23 Culprit vessels, 44 non-culprit vessels & 9 left main vessels. Mean syntax score 17.5 ± 8.0. sixty one intermediate lesions were detected with higher fibrofatty structure. Negative remodeling in 51% of lesions. 29 lesions in culprit vessels & 32 lesions in non-culprit vessels with higher lipidic content in lesions of culprit vessels (P<0.001) while there was a higher calcific content in lesions of non-culprit vessels (P<0.001). 27 lesions were subjected to revascularization based on IVUS measures. QCA Minimum lumen diameter was significantly lower (P=0.002) and percent diameter stenosis was significantly higher in revascularization group (P=0.02). MLA was significantly lower (P<0.001) and Percent area stenosis was significantly higher in revascularization group (P<0.001). MLA & plaque burden are the main predictors for lesion anatomical significance with (P <0.001, OR=0.25, 95% CI = 0.12-0.55) and (P=0.011 , OR=2.0 , 95% CI = 1.2-3.3) respectively related to the use of IVUS