Association between cholesterol crystals and culprit lesion vulnerability in patients with acute coronary syndrome: An optical coherence tomography study
Association between cholesterol crystals and culprit lesion vulnerability in patients with acute coronary syndrome: An optical coherence tomography study
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急性冠状动脉综合征患者胆固醇晶体与罪魁祸首易损性之间的关联：光学相干断层扫描研究
DOI：
10.1016/j.atherosclerosis.2016.02.010
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发表时间：
2016-04-01
期刊：
影响因子：
5.3
通讯作者：
Yu, Bo
中科院分区：
文献类型：
--
作者：
Dai, Jiannan;Tian, Jinwei;Yu, Bo
背景：胆固醇晶体（ChCs）被认为是晚期动脉粥样硬化病变的标志。先前的动物和组织病理学研究表明，胆固醇结晶会引发局部炎症反应和斑块破裂。我们试图研究急性冠脉综合征 (ACS) 患者体内 ChC 与罪犯病变易损性之间的关系。方法：对 206 名接受光学相干断层扫描 (OCT) 成像的 ACS 患者的 206 个罪犯病变根据是否存在 ChC 将其分为 2 组。比较 ChCs 组和非 ChCs 组之间的罪魁祸首特征。 结果：对于整体 ACS 患者，ChCs 罪魁祸首具有更高的巨噬细胞积聚发生率（77.8% vs. 40.0%，p < 0.001）、微通道发生率（67.9% vs. 24.8%，p < 0.001）、斑块破裂发生率（58.0% vs. 24.0%，p < 0.001）。 36.0%，p = 0.001）、血栓形成（66.7% vs. 49.6%，p = 0.016）和点状钙化（35.8% vs. 10.4%，p < 0.001）。此外，平均脂质弧（274.2 +/- 57.6 度与 228.1 +/- 66.3 度，p < 0.001）较大，脂质指数（3826.1 +/- 2111.4 与 2855.0 +/- 1753.0，p = 0.001）也较大。与 NSTEACS 患者相比，STEMI 患者的 ChC 频率显着更高（50.8% vs. 34.7%，p = 0.032）。 STEMI（分别为 p = 0.028、p < 0.001 和 p = 0.002）和 NSTEACS（分别为 p < 0.001、p < 0.001 和 p < 0.001）亚组中，在 ChC 的罪魁祸首中观察到较大的脂质弧、巨噬细胞积聚和微通道的发生率较高。 结论：ChC 经常与易受伤害的特征相关 ACS 罪魁祸首以及 STEMI 和 NSTEACS 亚组中的斑块。与 NSTEACS 患者相比，STEMI 患者的罪魁祸首病变中更常观察到 ChC 和易损斑块特征。 (C) 2016 Elsevier Ireland Ltd. 保留所有权利。
Background: Cholesterol Crystals (ChCs) are recognized as a hallmark of advanced atherosclerotic lesions. Previous animal and histopathology studies have revealed that Cholesterol crystallization trigger a local inflammatory response and plaque rupture. We sought to investigate the in vivo relationship between ChCs and culprit lesion vulnerability in patients with acute coronary syndrome (ACS).Methods: 206 culprit lesions from 206 patients with ACS who underwent optical coherence tomography (OCT) imaging were divided into 2 groups based on the presence or absence of ChCs. Culprit lesions characteristics were compared between ChCs and Non-ChCs groups.Results: For overall ACS patients, culprit lesions with ChCs had higher incidence of macrophages accumulation (77.8% vs. 40.0%, p < 0.001), microchannel (67.9% vs. 24.8%, p < 0.001), plaque rupture (58.0% vs. 36.0%, p = 0.001), thrombosis (66.7% vs. 49.6%, p = 0.016) and spotty calcification (35.8% vs. 10.4%, p < 0.001). In addition, the mean lipid arc (274.2 +/- 57.6 degrees vs. 228.1 +/- 66.3 degrees, p < 0.001) was larger and the lipid index (3826.1 +/- 2111.4 vs. 2855.0 +/- 1753.0, p = 0.001) was greater. The frequency of ChCs was significantly higher in patients with STEMI, as compared with NSTEACS (50.8% vs. 34.7%, p = 0.032). Larger lipid arc, higher incidence of macrophages accumulation and that of microchannel were observed in culprit lesions with ChCs in both STEMI (p = 0.028, p < 0.001, and p = 0.002 respectively) and NSTEACS (p < 0.001, p < 0.001, and p < 0.001 respectively) subgroups.Conclusion: ChCs were frequently associated with characteristics of vulnerable plaques in ACS culprit lesions as well as in STEMI and NSTEACS subgroups. ChCs and vulnerable plaque features were more often observed in culprit lesions of STEMI patients compared to NSTEACS patients. (C) 2016 Elsevier Ireland Ltd. All rights reserved.