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High Coronary Wall Shear Stress Worsens Plaque Vulnerability: A Systematic Review and Meta-Analysis
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine. University College, Bardhosh, Kosovo; Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo.ORCID iD: 0000-0002-8996-4257
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine. Molecular and Clinic Research Institute, St George University, London, andBrunel University, United Kingdom.ORCID iD: 0000-0002-6089-5614
2021 (English)In: Angiology, ISSN 0003-3197, E-ISSN 1940-1574, Vol. 72, no 8, p. 706-714Article, review/survey (Refereed) Published
Abstract [en]

Aim: The aim of this meta-analysis is to assess the impact of wall shear stress (WSS) severity on arterial plaque vulnerability.

Methods: We systematically searched electronic databases and selected studies which assessed the relationship between WSS measured by intravascular ultrasound and coronary artery plaque features. In 7 studies, a total of 615 patients with 28 276 arterial segments (median follow-up: 7.71 months) were identified. At follow-up, the pooled analysis showed high WSS to be associated with regression of plaque fibrous area, weighted mean difference (WMD) −0.11 (95% CI: −0.20 to −0.02, P = .02) and fibrofatty area, WMD −0.09 (95% CI: −0.17 to −0.01, P = .02), reduction in plaque total area, WMD −0.09 (95% CI: −0.14 to −0.04, P = .007) and increased necrotic core area, and WMD 0.04 (95% CI: 0.01-0.09, P = .03) compared with low WSS. Dense calcium deposits remained unchanged in high and low WSS (0.01 vs 0.02 mm2; P > .05). High WSS resulted in profound remodeling (40% vs 18%, P < .05) and with more constructive remodeling than low WSS (78% vs 40%, P < .01).

Conclusions: High WSS in coronary arteries is associated with worsening plaque vulnerability and more profound arterial wall remodeling compared with low WSS.

Place, publisher, year, edition, pages
Sage Publications, 2021. Vol. 72, no 8, p. 706-714
Keywords [en]
coronary artery disease, intravascular ultrasound, wall shear stress
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:umu:diva-180770DOI: 10.1177/0003319721991722ISI: 000637904400001PubMedID: 33535802Scopus ID: 2-s2.0-85100695421OAI: oai:DiVA.org:umu-180770DiVA, id: diva2:1531146
Available from: 2021-02-25 Created: 2021-02-25 Last updated: 2022-04-26Bibliographically approved

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Bajraktari, ArtanBytyci, IbadeteHenein, Michael Y.

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