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Cardiology Research and Practice
Volume 2011, Article ID 687515, 7 pages
Clinical Study

Optical Coherence Tomography Analysis of Attenuated Plaques Detected by Intravascular Ultrasound in Patients with Acute Coronary Syndromes

1Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8510, Japan
2Department of Cardiovascular Medicine, Social Insurance Kinan Hospital, 46-70, Shinjyo-cho, Tanabe 646-8588, Japan

Received 27 May 2011; Accepted 14 July 2011

Academic Editor: Igor Klem

Copyright © 2011 Takashi Kubo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Recent intravascular ultrasound (IVUS) studies have demonstrated that hypoechoic plaque with deep ultrasound attenuation despite absence of bright calcium is common in acute coronary syndrome. Such “attenuated plaque” may be an IVUS characteristic of unstable lesion. Methods. We used optical coherence tomography (OCT) in 104 patients with unstable angina to compare lesion characteristics between IVUS-detected attenuated plaque and nonattenuated plaque. Results. IVUS-detected attenuated plaque was observed in 41 (39%) patients. OCT-detected lipidic plaque (88% versus 49%, 𝑃 < 0 . 0 0 1 ), thin-cap fibroatheroma (48% versus 16%, 𝑃 < 0 . 0 0 1 ), plaque rupture (44% versus 11%, 𝑃 < 0 . 0 0 1 ), and intracoronary thrombus (54% versus 17%, 𝑃 < 0 . 0 0 1 ) were more often seen in IVUS-detected attenuated plaques compared with nonattenuated plaques. Conclusions. IVUS-detected attenuated plaque has many characteristics of unstable coronary lesion. The presence of attended plaque might be an important marker of lesion instability.