{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T05:11:09Z","timestamp":1789103469128,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","license":[{"start":{"date-parts":[[2019,3,11]],"date-time":"2019-03-11T00:00:00Z","timestamp":1552262400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiology Research and Practice"],"published-print":{"date-parts":[[2019,3,11]]},"abstract":"<jats:p><jats:italic>Background<\/jats:italic>. Non-ST elevation acute coronary syndromes (NSTE-ACS) may arise from moderately stenosed atherosclerotic lesions that suddenly undergo transformation to vulnerable plaques complicated by rupture and thrombosis. <jats:italic>Objective<\/jats:italic>. Assessment and tissue characterization of the coronary atherosclerotic lesions among NSTE-ACS patients compared to those with stable angina. <jats:italic>Methodology<\/jats:italic>. Evaluation of IVUS studies of 312 coronary lesions was done by 2 different experienced IVUS readers, 216 lesions in 66 patients with NSTE-ACS (group I) versus 96 lesions in 50 patients with stable angina (group II). Characterization of coronary plaques structure was done using colored-coded iMap technique. <jats:italic>Results<\/jats:italic>. The Syntax score was significantly higher in group I compared to group II (18.7\u2009\u00b1\u20097.8 vs. 8.07\u2009\u00b1\u20092.5, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mrow><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:mrow><\/mml:math>). Body mass index (BMI) was significantly higher in group II while triglycerides levels were higher in group I (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mrow><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.01<\/mml:mn><\/mml:mrow><\/mml:math> &amp; <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><mml:mrow><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.04<\/mml:mn><\/mml:mrow><\/mml:math>, respectively). History of previous MI and PCI was significantly higher in group I (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><mml:mrow><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.016<\/mml:mn><\/mml:mrow><\/mml:math> &amp; <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\"><mml:mrow><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:mrow><\/mml:math>, respectively). The coronary lesions of NSTE-ACS patients had less vessel area (9.86\u2009\u00b1\u20093.8 vs 11.36\u2009\u00b1\u20092.9, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\"><mml:mrow><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:mrow><\/mml:math>), stenosis percentage (54.7\u2009\u00b1\u200914.9% vs 68.6\u2009\u00b1\u20098.7%, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\"><mml:mrow><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:mrow><\/mml:math>), and plaque burden (54.4\u2009\u00b1\u200914.7 vs 67.8\u2009\u00b1\u20099.8, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M8\"><mml:mrow><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:mrow><\/mml:math>) with negative remodeling index (0.95\u2009\u00b1\u200920 vs 1.02\u2009\u00b1\u20090.14, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M9\"><mml:mrow><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.008<\/mml:mn><\/mml:mrow><\/mml:math>) compared to the stable angina group. On the other hand, they had more lipid content (21.8\u2009\u00b1\u20097.03% vs 7.26\u2009\u00b1\u20093.47%, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M10\"><mml:mrow><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:mrow><\/mml:math>), necrotic core (18.08\u2009\u00b1\u200910.19% vs 15.83\u2009\u00b1\u20094.9%, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M11\"><mml:mrow><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.02<\/mml:mn><\/mml:mrow><\/mml:math>), and calcifications (10.4\u2009\u00b1\u20095.2% vs 4.19\u2009\u00b1\u20093.29%, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M12\"><mml:mrow><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:mrow><\/mml:math>) while less fibrosis (51.67\u2009\u00b1\u20097.07% vs 70.37\u2009\u00b1\u200911.7%, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M13\"><mml:mrow><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:mrow><\/mml:math>) compared to the stable angina patients. Syntax score and core composition especially calcification and lipid content were significant predictors to NSTE-ACS. <jats:italic>Conclusions<\/jats:italic>. The vulnerability rather than the stenotic severity is the most important factor that predisposes to non-ST segment elevation acute coronary syndromes. The vulnerability is related to the lesion characteristics especially lipidic core and calcification while lesion fibrosis favours lesion stability.<\/jats:p>","DOI":"10.1155\/2019\/2642740","type":"journal-article","created":{"date-parts":[[2019,3,11]],"date-time":"2019-03-11T19:30:27Z","timestamp":1552332627000},"page":"1-7","source":"Crossref","is-referenced-by-count":9,"title":["Coronary Atherosclerotic Plaque Vulnerability Rather than Stenosis Predisposes to Non-ST Elevation Acute Coronary Syndromes"],"prefix":"10.1155","volume":"2019","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5069-2813","authenticated-orcid":true,"given":"Mohamed","family":"Laimoud","sequence":"first","affiliation":[{"name":"Critical Care Medicine Department, Kasr Alainy Hospitals, Cairo University, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farouk","family":"Faris","sequence":"additional","affiliation":[{"name":"Critical Care Medicine Department, Kasr Alainy Hospitals, Cairo 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