Plaque Morphology, Plaque Composition and Spatial Distribution of the Sites of Potential Vulnerability of Culprit Lesions Implicated in Acute Myocardial Infarction

Background: The role of plaque morphology, composition, and spatial distribution in plaque rupture and coronary occlusion in patients suffering acute myocardial infarction (AMI) needs clarification. Using color-mapping iMAP intravascular ultrasound (iMAP-IVUS), we examined culprit lesions to clarify plaque morphology, plaque composition and spatial distribution of the sites of potential vulnerability. Methods: Sixty-eight culprit lesions in 64 consecutive AMI patients who underwent angiography and IVUS examinations before intervention were analyzed. Plaque morphology and composition were quantified and compared between totally occlusive (TO) (n=42) and non-TO lesions and between ruptured (n=27) and non-ruptured lesions. Results: Both the length and plaque burden (PB) of TO lesions were greater than those of non-TO lesions (54.16 ± 21.16 mm versus 40.01 ± 17.51 mm, respectively, p = 0.006; PB: 0.63 ± 0.07 versus 0.58 ± 0.08, respectively, p = 0.02). Ruptured lesions were coincident with significant vessel ...