Predictors for layered coronary plaques: an optical coherence tomography study View Full Text


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Article Info

DATE

2020-04-18

AUTHORS

Makoto Araki, Taishi Yonetsu, Michele Russo, Osamu Kurihara, Hyung Oh Kim, Hiroki Shinohara, Vikas Thondapu, Tsunenari Soeda, Yoshiyasu Minami, Takumi Higuma, Hang Lee, Tsunekazu Kakuta, Ik-Kyung Jang

ABSTRACT

Healed coronary plaques, morphologically characterized by a layered pattern, are signatures of previous plaque disruption and healing. Recent optical coherence tomography (OCT) studies showed that layered plaque is associated with vascular vulnerability. However, factors associated with layered plaques have not been studied. The aim of this study was to investigate predictors for layered plaque at the culprit plaques and at non-culprit plaques. Patients with coronary artery disease who underwent pre-intervention OCT imaging of the culprit lesion were included. Layered plaques were defined as plaques with one or more layers of different optical density and a clear demarcation from underlying components. Among 313 patients, layered plaque at the culprit lesion was observed in 18.8% of ST-segment elevation myocardial infarction patients, 36.3% of non-ST-segment elevation acute coronary syndrome patients, and 53.4% of stable angina pectoris (SAP) patients (p < 0.001). In the multivariable model, SAP, multivessel disease, type B2/C lesion, and diameter stenosis > 70% were independent predictors for layered plaque at the culprit lesion. In addition, 394 non-culprit plaques in 190 patients were assessed to explore predictors for layered plaques at non-culprit lesions. SAP, and thin-cap fibroatheroma and layered plaque at the culprit lesion were independent predictors for layered plaques at non-culprit lesions. In conclusion, clinical presentation of SAP was a strong predictor for layered plaque at both culprit plaques and non-culprit plaques. Development and biologic significance of layered plaques may be related to a balance between pan-vascular vulnerability and endogenous anti-thrombotic protective mechanism. More... »

PAGES

886-894

References to SciGraph publications

  • 2014-04-29. Clinical classification of plaque morphology in coronary disease in NATURE REVIEWS CARDIOLOGY
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s11239-020-02116-5

    DOI

    http://dx.doi.org/10.1007/s11239-020-02116-5

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/32306291


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    82 predictors
    83 presentation
    84 protective mechanism
    85 sap
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    87 signatures
    88 significance
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