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April 26, 3:00 pm ~ April 27


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AS-013
atherosclerotic plaques morphology and serous hypersensitive C-reactive protein in patients with premature coronary heart disease
Fuwai Hospital, Beijing, China; 1Beijing University shougang hospital, Beijng, China; 2The affiliated hospital of tianjin medical univercity , Tianjin, China
J.L. Gao, A.R. Xie1, J. Chen2, L.J. Chen, J.Y. Yang, B. Xu, B.S. Qiao, J.J. Li, J. Qian, L.R. Gao
Background:
The current study on premature CHD stenosis mainly focus on coronary artery angiography or heart transplantation donor, but few study are conducted in vivo.
Methods:
From April 2004 to April 2007, 620 patients were examined by IVUS, 175 patients (118 patients with premature CHD and 57 patients with late CHD) were enrolled according to the plaque characteristics,as well as plasma hypersensitive C-reaction protein were tested,  in this study. Comparative study is conducted on 57 patients of premature CHD and 57 patients of late CHD whose data were intact and could be analyzed, and the clinical follow-up is also completed at 12 months after the procedure.
Results:
among the 118 patients of premature CHD, the ratio of lipid core measured by IVUS to plaque of coronary artery was in linear relationship with plasma hypersensitive CRP (R=0.298£¬R2=0.088£¬p<0.001). Comparison between premature CHD patients and late CHD patients, we found that the former has more patients with family history of CHD, smoking, myocardial infarction, hyperlipaemia and unstable angina pectoris (all the P value <0.05), while the latter has more patients with diabetes. There was no difference between the two groups on the morphology of the lesions by coronary artery angiography. But we could found that lesion extent, cross-sectional areas surrounded by external elastic membrane, eccentricity index (EI), plaque plus medial area (MA), positive remodeling, plaque burden and the ratio of lipid core to plaque by IVUS were usually seen in the group of premature CHD patients (all the P value <0.05). There was no difference on major adverse cardiac events [MACE, including all-cause death, target-vessel revascularization (TVR), Target lesion revascularization (TLR) and stent thrombosis] rate between the two groups at 12-month clinical follow-up. The MACE rate was 7.89%£¨9/114£©. Three and four patients suffered from TVR and TLR and two patients died. There was only 1 patient dead from late stent thrombosis in the two groups (0.87%).
Conclusion:
compared with late CHD patients, the coronary artery atherosclerotic plaque of premature CHD patients has higher percentage of unstable plaque. The ratio of lipid core to plaque is in positive correlation with plasma hypersensitive CRP in a certain patients. Positive remodeling is a common phenomenon in premature CHD patients.