Plaque disruption and thrombus in Ambrose’s angiographic coronary lesion types

Waxman, Sergio; Mittleman, Murray A.; Zarich, Stuart; Fitzpatrick, Philip; Lewis, Stanley M.; Leeman, David; Shubrooks, Samuel J.; Abela, George S.; Nesto, Richard W.

doi:10.1016/s0002-9149(03)00457-0

Cited by 37 publications

(28 citation statements)

References 24 publications

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“…[14][15][16][17][18][19] To some extent, the same morphologic features may explain the association between eccentric carotid plaques and cerebrovascular events. In addition, hemodynamic changes induced by eccentric stenosis may be an important factor that leads to cerebrovascular events.…”

Section: Discussionmentioning

confidence: 96%

“…28 (22) 67 (17) . bifurcation models demonstrated that there were differences between eccentric and concentric stenosis with respect to the size of the poststenotic recirculation zone, as well as the severity and distribution of wall shear stress.…”

Section: Discussionmentioning

confidence: 99%

“…[14][15][16][17][18][19] A prospective observational study using intravascular sonography found that, in all of the acute coronary syndrome patients, the pre-existing coronary lesions showed eccentric stenosis. 16 The reason for this association appears to be that the eccentric plaque is a vulnerable plaque and may indicate disruption and superimposed thrombus.…”

mentioning

confidence: 99%

“…16 The reason for this association appears to be that the eccentric plaque is a vulnerable plaque and may indicate disruption and superimposed thrombus. 17 In the carotid arteries, plaque eccentricity may also be an important marker of subsequent ischemic stroke. However, the correlation between the geometry of the carotid artery stenosis and cerebrovascular events has not been determined.…”

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confidence: 99%

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Eccentric Stenosis of the Carotid Artery Associated with Ipsilateral Cerebrovascular Events

Ohara

Toyoda²,

Otsubo³

et al. 2008

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Eccentric Stenosis of the Carotid Artery Associated with Ipsilateral Cerebrovascular Events

Ohara

Toyoda²,

Otsubo³

et al. 2008

AJNR Am J Neuroradiol

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“…A number of previous studies have demonstrated that angiographically the culprit lesions in patients with UAP often appear irregular and contain filling defects likely to represent plaque disruption and/or plaque thrombus. [13][14][15][16] Previous clinical studies have also revealed that angiographically detected complex lesions correlated with higher Braunwald class. 17,18 However, it has also been shown that patients with Braunwald class I occasionally show angiographic evidence of a complex lesion.…”

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confidence: 95%

Elevated Plasma Levels of Oxidized Low-Density Lipoprotein Relate to the Presence of Angiographically Detected Complex and Thrombotic Coronary Artery Lesion Morphology in Patients With Unstable Angina

Yamashita

Ehara

Yoshiyama

et al. 2007

Circ J

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he role of inflammation in patients with acute coronary syndromes (ACS) is presently undisputed, supported by histopathological studies of unstable coronary plaque, 1 as well as clinical studies of elevated circulating acute-phase reactants. 2,3 Oxidized low-density lipoprotein (ox-LDL) is generally considered to be a key factor in the genesis of the inflammatory process in atherosclerotic lesions 4,5 and the detection of ox-LDL in human plasma has opened new avenues of the study of its relationship to the atherosclerotic process. [6][7][8][9][10] We developed a sandwich enzyme-linked immunosorbent assay (ELISA) method to measure plasma ox-LDL levels, using a specific anti-ox-LDL monoclonal antibody (DLH3) and an antiCirculation Journal Vol.71, May 2007 apolipoprotein B (apoB) polyclonal antibody. 11,12 DLH3 is specific for ox-LDL because it recognizes oxidized phosphatidylcholines (ox-PC) molecules 11 and does not bind to native, acetylated, malondialdehyde-treated, or glycated low-density lipoprotein (LDL). Using this new and highly sensitive method, we have reported that in patients with acute myocardial infarction (AMI) the plasma levels of ox-LDL are significantly higher than in patients with unstable angina pectoris (UAP) or stable angina pectoris (SAP), or in controls. 7 Recently, we also demonstrated that persistence of an increased plasma level of ox-LDL at discharge is a strong independent predictor of stent restenosis at 6-month follow-up in AMI patients. 10 UAP as a clinical diagnosis incorporates a diverse group of clinical presentations that occupy an intermediate position between the more strictly defined clinical entities of AMI and SAP. A number of previous studies have demonstrated that angiographically the culprit lesions in patients with UAP often appear irregular and contain filling defects likely to represent plaque disruption and/or plaque thrombus. [13][14][15][16] Previous clinical studies have also revealed that angiographically detected complex lesions correlated with higher Braunwald class. 17,18 However, it has also been shown that patients with Braunwald class I occasionally show angiographic evidence of a complex lesion. 17,18 Hence, given the role of ox-LDL in plaque instability in Hiroyuki Itabe, PhD † ; Toru Kataoka, MD; Yoshiki Kobayashi, MD; Anton E. Becker, MD ‡ ; Junichi Yoshikawa, MD † † ; Makiko Ueda, MD** Background Increased levels of oxidized low-density lipoprotein (ox-LDL) are related to plaque instability, so the aim of the present study was to investigate whether there is a relationship between angiographic coronary plaque morphology in patients with unstable angina pectoris (UAP) and the level of ox-LDL. Methods and ResultsPlasma ox-LDL levels were measured in 149 patients with UAP and in 88 control subjects, using a highly sensitive enzyme-linked immunosorbent assay method. Angiographic morphology of the culprit lesion was classified as either simple or complex based on the Ambrose classification. Plasma ox-LDL levels in patients with Braunwald class III were s...

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Atherosclerotic Heart Disease

Saam¹

2013

Geriatric Imaging

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Plaque disruption and thrombus in Ambrose’s angiographic coronary lesion types

Cited by 37 publications

References 24 publications

Eccentric Stenosis of the Carotid Artery Associated with Ipsilateral Cerebrovascular Events

Eccentric Stenosis of the Carotid Artery Associated with Ipsilateral Cerebrovascular Events

Elevated Plasma Levels of Oxidized Low-Density Lipoprotein Relate to the Presence of Angiographically Detected Complex and Thrombotic Coronary Artery Lesion Morphology in Patients With Unstable Angina

Atherosclerotic Heart Disease

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