혈중 hs-CRP와 관상동맥경화증 중등도 및 죽상반 취약성과의 연관 관계에 대한 연구

Alternative Title
Se Jun Park
Author(s)
Park, Se Jun
Alternative Author(s)
Se Jun Park
Advisor
탁승제
Department
일반대학원 의학과
Publisher
The Graduate School, Ajou University
Publication Year
2013-08
Language
eng
Keyword
high sensitive C-reactive proteinhs-CRPcoronary atherosclerosisvirtual histologyintravascular ultrasoundvulnerable plaquevulnerability
Alternative Abstract
Background: hs-CRP (high sensitive C-reactive protein) has been known as a systemic inflammatory marker of atherosclerosis and considered as one of the predictors of future cardiac events. Some reports presented hs-CRP level was associated with plaque vulnerability but most studies were performed by assessing focal target plaque but not whole plaques from a coronary tree. Methods: To evaluate of the relationship of plasma hs-CRP level and volumetric plaque composition of the coronary arterial tree, we performed ‘whole vessel” virtual histology-intravascular ultrasound (VH-IVUS) in 189 vessels of 63 patients. The components of atherosclerosis were classified as fibrous (FI), fibrous-fatty (FF), necrotic core (NC) and dense calcium (DC). Quantitative assessment of these plaque components and the presence of VH-IVUS–derived thin-cap fibroatheroma (VH-TCFA) in the coronary arterial trees were compared to hs-CRP levels in individuals. hs-CRP levels were measured before coronary angiogram and IVUS study. Results: Forty-nine patients (77.8%) were diagnosed with acute coronary syndrome in this population. The mean values of hs-CRP were 0.24±0.52 mg/dl (0~3.27mg/dl). The analyzed vessel length was 56.1±17.4 mm for the left anterior descending coronary artery, 51.9±19.0 mm for the left circumflex coronary artery, and 74.2±18.8 mm for the right coronary artery. The number of VH-TCFAs was 1.0±0.8 for the left anterior descending, 0.6±0.7 for the left circumflex, and 0.8±1.0 for the right coronary arteries.The hs-CRP levels were positively correlated to mean plaque burden, total plaque volume index, volume index of FF and DC. But parameters of NC and the number of VH-TCFA were not related with hs-CRP level. In multivariate analysis, the volume index of DC was most reliable factor to hs-CRP (β=3.646, CI=2.036 to 5.255, p<0.001) Conclusions: This three-vessel VH-IVUS presented that hs-CRP were related to the total atherosclerotic burden and the maturing (coronary calcium) but not vulnerable features (NC or VH-TCFA) of plaques in coronary arterial tree. Increased hs-CRP level as a biomarker to predict cardiovascular events might imply atherosclerosis severity of whole coronary tree but not current plaque vulnerability.
URI
https://dspace.ajou.ac.kr/handle/2018.oak/18263
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Graduate School of Ajou University > Department of Medicine > 3. Theses(Master)
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