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Abstract
Identification of subclinical high-risk plaques is potentially important because they may have greater likelihood for rupture and subsequent thrombosis. Intravascular ultrasound virtual histology (IVUS-VH) has the ability to classify plaque components in vivo into one of four categories: fibrous, fibro-fatty, necrotic or calcified. It is not well established whether IVUS-VH imaging may identify coronary plaques that are vulnerable to thrombosis and thereby patients that are at high risk for future events. Pending outcome data of longitudinal studies, we compared coronary artery plaque composition using IVUS-VH to the cardiovascular risk estimates predicted by established clinical risk scores.
Forty consecutive patients undergoing elective coronary angiography revealing <50% coronary artery stenoses were prospectively included in this observational study, conducted at the Heart Center of the Segeberger Kliniken (Academic Teaching Hospital of the University of Kiel) in Bad Segeberg, Germany. Of these, 38 (29 men; mean age 65±9 years) underwent a satisfactory IVUS-VH investigation of the affected vessel. For each patient, the 10-year risk of cardiovascular events was calculated using the Framingham and the SCORE-Deutschland risk prediction algorithms, and compared to the VH-derived plaque composition at the site of the minimal lumen area (MLA).