Prevalence and Predictors of Multiple Coronary Plaque Ruptures: In Vivo 3-Vessel Optical Coherence Tomography Imaging Study

Luigi Marzio Biasucci, Filippo Crea, Rocco Vergallo, Shiro Uemura, Tsunenari Soeda, Yoshiyasu Minami, Jin-Man Cho, Daniel S. Ong, Aaron D. Aguirre, Lei Gao, Bo Yu, Hang Lee, Chong-Jin Kim, Ik-Kyung Jang

Risultato della ricerca: Contributo in rivistaArticolo in rivista

23 Citazioni (Scopus)

Abstract

Objective - Plaque rupture may be the local expression of a widespread coronary instability. This study aimed to investigate: (1) the prevalence and characteristics of nonculprit plaque rupture; (2) the pancoronary atherosclerotic phenotype in patients with and without nonculprit plaque rupture; and (3) the prevalence and predictors of multiple plaque ruptures. Approach and Results - Six hundred and seventy-five nonculprit plaques from 261 patients (34 acute myocardial infarction, 73 unstable angina pectoris, and 154 stable angina pectoris) were analyzed by 3-vessel optical coherence tomography. Nonculprit plaque ruptures were identified in 51 patients (20%). Patients with nonculprit plaque ruptures had higher prevalence of thin-cap fibroatheroma (51% versus 13%; P<0.001) in the 3 major epicardial coronary vessels. Multiple plaque ruptures were observed in 20% of patients (38% acute myocardial infarction versus 10% unstable angina pectoris versus 19% stable angina pectoris; P=0.042). Thin-cap fibroatheroma, intimal vasculature, and macrophages were independent morphological predictors of multiple plaque ruptures, whereas acute myocardial infarction and chronic kidney disease were independent clinical predictors. Patients with nonculprit plaque ruptures showed higher 1-year rates of nontarget lesion revascularization (11.8% versus 4.4%; P=0.039). Conclusions - Nonculprit plaque ruptures were observed in 20% of patients with coronary artery disease and were associated with pancoronary vulnerability and higher 1-year revascularization rate.
Lingua originaleEnglish
pagine (da-a)2229-2238
Numero di pagine10
RivistaArteriosclerosis, Thrombosis, and Vascular Biology
Volume36
DOI
Stato di pubblicazionePubblicato - 2016

Keywords

  • Cardiology and Cardiovascular Medicine
  • atherosclerosis
  • fibroatheroma
  • incidence
  • optical coherence tomography
  • phenotype

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