Background: OCT with its unique image resolution is the ideal method to
detect culprit lesion characteristics in different clinical
presentations. The identification of inflammatory markers related to
plaque characteristics may be of clinical importance.
Methods: Thirty-two patients with acute coronary syndromes (ACS) and
fourteen patients with stable angina pectoris (SAP) were enrolled in
this study. Culprit lesion morphology was assessed by optical coherence
tomography (OCT) in patients with ACS and SAP. The possible relations
between serum levels of high sensitivity-C reactive protein (hs-CRP) and
interleukin-18 (IL-18) with plaque characteristics were investigated in
those patients.
Results: Plaque rupture and thin-cap fibroatheroma (TCFA) were detected
more frequently in ACS patients compared with SAP patients, (78.6% vs.
14.3%, p<0.001, 92.9% vs. 14.3%, p<0.001, respectively). Higher
levels of serum hs-CRP and IL-18 were found in patients with plaque
rupture vs. those with no plaque rupture (median value: 19.2 mg/L vs.
1.6 mg/L, p<0.001 and 219.5 pg/ml vs. 127.5 pg/ml, p=0.001
respectively), and TCFA vs. those without TCFA (median value: 15.2 mg/L
vs. 1.6 mg/L, p=0.004 and 209.0 pg/ml vs. 153.2 pg/ml, p=0.03
respectively). Serum hs-CRP was the only independent predictor of plaque
rupture (p=0.02, odds ratio 1.1, 95% confidence interval 1.0 to 1.2). A
cut-off value of hs-CRP>4.5 mg/L could detect ruptured plaque with a
sensitivity of 91.7% and a specificity of 77.8%.
Conclusions: OCT detected plaque rupture and TCFA more frequent in ACS
patients compared with SAP. Elevated hs-CRP and IL-18 were positively
related to plaque instability and rupture. (C) 2010 Elsevier Ireland
Ltd. All rights reserved
