Heart 2001;85:402-406 ( April )

Cardiovascular medicine

Lesion characteristics of acute myocardial infarction: an investigation with intravascular ultrasound D Fukuda^a, T Kawarabayashi^b, A Tanaka^b, Y Nishibori^b, H Taguchi^b, Y Nishida^b, K Shimada^a, J Yoshikawa^a

^a First Department of Internal Medicine, Osaka City University Medical School, Osaka, Japan, ^b Department of Cardiology, Baba Memorial Hospital, 4-244, Hamadera-funao-cho Higashi, Sakai, 592-8555 Japan

Correspondence to: Dr Kawarabayashi takahiko{at}msic.med.osaka-cu.ac.jp

Accepted 8 November 2000

OBJECTIVETo use intravascular ultrasound (IVUS) to compare plaque morphology in acute myocardial infarction and stable angina pectoris.
DESIGNRetrospective study.
SETTINGPrimary care hospital.
PATIENTS59 consecutive cases of acute myocardial infarction and 50 consecutive cases of stable angina pectoris.
METHODSIVUS was used before coronary intervention.
MAIN OUTCOME MEASURESPlaque morphology (incidence of eccentric plaque, subtle dissections, low echoic thrombus, calcification, echolucent areas, and bright speckled echo material), assessed visually using IVUS.
RESULTSThere were no significant differences in plaque eccentricity or calcification between the two groups, but low echoic thrombus (acute myocardial infarction 15% v stable angina pectoris 0%), subtle dissections (37% v 4%), echolucent areas (31% v 0%), and bright speckled echo material (90% v 0%) were more common in the infarction group than in the stable angina group (p < 0.001 for all). There was a longer time between the onset of symptoms and the IVUS examination in patients with low echoic thrombus than in those without (p < 0.03).
CONCLUSIONSLow echoic thrombus, subtle dissections, echolucent areas, and bright speckled echo material are morphological characteristics associated with plaque at the time of acute myocardial infarction. These findings correspond pathologically to ruptured plaque.


Keywords: intravascular ultrasound; acute myocardial infarction; plaque morphology

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© 2001 by Heart
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