Plaque Progression in Coronary Arteries With Minimal Luminal Obstruction in Intravascular Ultrasound Atherosclerosis Trials

Andrea J. Lavoie, Ozgur Bayturan, Kiyoko Uno, Amy Hsu, Kathy Wolski, Paul Schoenhagen, Samir Kapadia, E. Murat Tuzcu, Steven E. Nissen, Stephen J. Nicholls

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12 Citations (Scopus)


The relation among the burden of disease, progression of atherosclerosis, and remodeling in angiographically minimally diseased coronary arteries has not been defined. The present analysis included 1,906 patients who participated in 5 prospective clinical trials examining atheroma progression using intravascular ultrasonography. For the present analysis, the patients were stratified according to baseline quantitative coronary angiographic stenosis: <20%, 20% to 35%, and >35%. Patients with a lesser degree of luminal stenosis had less atherosclerosis. However, in the arteries with minimal angiographic stenosis, a large percentage of images contained atheroma, demonstrating the diffuse nature of coronary atherosclerosis. All 3 groups showed evidence of disease progression. The serial changes in vessel dimensions revealed that both the external elastic membrane and lumen volumes decreased in all 3 subgroups, in keeping with vessel and luminal constriction. In conclusion, these findings have demonstrated that patients with at least one luminal stenosis have diffuse atherosclerosis that progressed during 18 to 24 months, making them a target for therapeutic intervention. These minimally diseased arteries demonstrated evidence of vessel and luminal constriction, regardless of the angiographic appearance.

Original languageEnglish
Pages (from-to)1679-1683
Number of pages5
JournalThe American Journal of Cardiology
Issue number12
Publication statusPublished - 15 Jun 2010
Externally publishedYes

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