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서영훈,이충섭,육형빈,양동주,박현웅,김기홍,김완호,권택권,배장호 대한심장학회 2013 Korean Circulation Journal Vol.43 No.1
Background and Objectives: Hypercholesterolemia is a key factor in the development of atherosclerosis. We sought to evaluate the re-lation between hypercholesterolemia and plaque composition in patients with coronary artery disease. Subjects and Methods: Study subjects consisted of 323 patients (mean 61.5 years, 226 males) who underwent coronary angiography and virtual histology-intravascular ultrasound examination. Patients were divided into two groups according to total cholesterol level: hypercho-lesterolemic group (≥200 mg/dL, n=114) and normocholesterolemic group (<200 mg/dL, n=209). Results: Hypercholesterolemic patients were younger (59.7±13.3 years vs. 62.6±11.5 years, p=0.036), than normocholesterolemic patients,whereas there were no significant differences in other demographics. Hypercholesterolemic patients had higher corrected necrotic core volume (1.23±0.85 mm 3 /mm vs. 1.02±0.80 mm 3 /mm, p=0.029) as well as percent necrotic core volume (20.5±8.5% vs. 18.0±9.2%, p=0.016) than normocholesterolemic patients. At the minimal lumen area site, percent necrotic core area (21.4±10.5% vs. 18.4±11.3%, p=0.019) and necrotic core area (1.63±1.09 mm 2 vs. 1.40±1.20 mm 2 , p=0.088) were also higher than normocholesterolemic patients. Multi-variate linear regression analysis showed that total cholesterol level was an independent factor of percent necrotic core volume in the cul-prit lesion after being adjusted with age, high density lipoprotein-cholesterol , hypertension, diabetes mellitus, smoking and acute coro-nary syndrome (beta 0.027, 95% confidence interval 0.02-0.053, p=0.037). Conclusion: Hypercholesterolemia was associated with increased necrotic core volume in coronary artery plaque. This study suggests that hypercholesterolemia plays a role in making plaque more complex, which is characterized by a large necrotic core, in coronary artery dis-ease.
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