Evaluation of Variable Thin-Cap Fibroatheroma Definitions and Association of Virtual Histology-Intravascular Ultrasound Findings With Cavity Rupture Size Journal Article

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Authors: Hirai, T.; Chen, Z; Zhang, L; Baaj, S.; Kovarnik, T; Porcaro, K; Kaminski, J.; Hawn, S.; Agrawal, A.; Makki, N.; Downe, R.; Wahle, A; Sonka, M; Lopez, J. J.
Article Title: Evaluation of Variable Thin-Cap Fibroatheroma Definitions and Association of Virtual Histology-Intravascular Ultrasound Findings With Cavity Rupture Size
Abstract: The accepted definition of virtual histology intravascular ultrasound (IVUS-VH) thin-cap fibroatheroma (TCFA) is only a modest predictor of plaque rupture (PR). We sought to determine the relation between IVUS-VH findings and culprit lesions with PR using computational analysis. A total of 80 culprit lesions from 80 patients with stable angina (n = 37), unstable angina (n = 20), and myocardial infarction (n = 23) were divided into those with (n = 15) and without PR (n = 65). By use of automated computational analysis, the standard IVUS-VH TCFA criterion and 124 additional criteria were compared. The standard TCFA definition demonstrated modest ability to discriminate lesions with and without PR (sensitivity 87%, specificity 37%, PPV 0.24, and NPV 0.92). Of 124 additional IVUS-VH TCFA definitions, only 2 improved the discriminative ability even modestly. However, a positive correlation was demonstrated between cavity size and necrotic core percentage (r = 0.78, p 0.01) and a negative correlation with percentage of fibrous tissue (r = -0.81, p 0.01). In conclusion, IVUS-VH criteria were only modestly associated with PR, without significant improvement by varying IVUS-VH TCFA features, but IVUS-VH features of ruptured plaques were strongly correlated with cavity size.
Journal Title: The American Journal of Cardiology
Volume: 118
Issue: 2
ISSN: 1879-1913; 0002-9149
Publisher: Unknown  
Journal Place: United States
Date Published: 2016
Start Page: 162
End Page: 169
Language: eng
DOI/URL:

10.1016/j.amjcard.2016.04.050
Notes: CI: Copyright (c) 2016; JID: 0207277; 2016/02/20 [received]; 2016/04/19 [revised]; 2016/04/27 [accepted]; 2016/05/04 [aheadofprint]; ppublish