[Angiographic geometric predictors of myocardial infarction are not associated with ultrasonographic markers of plaque vulnerability].

Objective: Some angiographic geometric features of coronary lesions have recently been described as independent predictors of myocardial infarction. The purpose of this study was to correlate these geometric markers with intravascular ultrasound findings known to be associated with greater vulnerability to plaque rupture.

Methods: A total of 30 patients with stable coronary syndromes and de novo lesions (31 lesions) underwent coronary angiography and intravascular ultrasound (IVUS). For each lesion, angiographic geometric features (degree of symmetry, degree of stenosis, lesion length, and outflow angle) were correlated with the following ultrasound variables: type of plaque (soft, fibrous, mixed, or calcified), plaque burden and remodeling index.

Results: Mean lesion length was 9.2 +/- 4.4 mm, percent stenosis was 50.0% to 89.0% (mean 67.7 +/- 12.1%), inflow angles ranged from 8.48 degrees to 48.78 degrees (mean 24.0 +/- 11.4 degrees), outflow angles ranged from 8.30 degrees to 53.03 degrees (mean 23.8 +/- 11.7 degrees), and the symmetry index ranged from 0 to 1 (mean 0.56 +/- 0.32). On ultrasound evaluation, frequency of soft or calcified plaques, positive remodeling, and magnitude of plaque burden were not associated with any angiographic geometric feature (p > 0.05 for all analysis).

Conclusion: Angiographic geometric features that predispose to acute occlusion do not correlate with IVUS morphologic and quantitative findings associated with plaque vulnerability.