PREDICTION OF ACUTE CORONARY SYNDROMES BY PERCUTANEOUS CORONARY ANGIOSCOPY IN PATIENTS WITH STABLE ANGINA

To pinpoint the link between plaque characteristics and acute coronary syndromes, we performed a 12-month prospective follow-up study in 157 patients with stable angina pectoris in whom regular coronary plaques were observed by percutaneous coronary angioscopy. Acute coronary syn dromes occurred more frequently in patients with yellow plaque than in those with white plaques (11 of 39 vs 4 of 118; p=0.00021). Moreover, the syndromes occurred more frequently in patients with glistening ye llow plaques than in those with nonglistening yellow plaques (9 of 13 vs 2 of 26; p=0.00026). Thrombus arising from the ruptured identical p laques was confirmed by angioscopy as the culprit lesion of the syndro mes. The results indicate that acute coronary syndromes occur frequent ly and in a short time in patients with glistening yellow plaques and that angioscopy but not angiography is feasible for prediction of the syndromes.