NIRS-IVUS Assessment of OCT-Derived Healed Coronary Plaques

  • Terada Kosei
    Department of Cardiovascular Medicine, Wakayama Medical University Department of Cardiovascular Medicine, Shingu Municipal Hospital
  • Kubo Takashi
    Department of Cardiovascular Medicine, Wakayama Medical University Division of Cardiology, Tokyo medical University, Hachioji Medical Center
  • Khalifa Amir Kh. M.
    Department of Cardiovascular Medicine, Wakayama Medical University Department of Cardiovascular Medicine, Assiut university hospitals
  • Wang Wei-Ting
    Department of Cardiovascular Medicine, Wakayama Medical University Division of cardiology, Taipei Veterans General Hospital
  • Fujita Suwako
    Department of Cardiovascular Medicine, Wakayama Medical University
  • Madder Ryan D.
    Frederik Meijer Heart & Vascular Institute, Corewell Health, Grand Rapids

説明

<p> Aims: Healed plaque (HP) is associated with rapid plaque growth and luminal narrowing. Thin-cap fibroatheroma (TCFA) is recognized as a precursor lesion to plaque rupture. The aim of the present study was to compare the lipid size among optical coherence tomography (OCT)-derived HP, TCFA, and thick-cap fibroatheroma (ThCFA) using near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS).</p><p>Methods: The present study included 173 patients with acute myocardial infarction (AMI) who underwent percutaneous coronary intervention. Non-culprit lesions with angiographically intermediate stenosis were assessed by both OCT and NIRS-IVUS.</p><p>Results: The frequency of TCFA, HP, and ThCFA was 35 (20%), 53 (30%), and 85 (49%), respectively. Minimum lumen area was not significantly different between TCFA and HP, but was smaller in TCFA and HP than in ThCFA (4.6 [interquartile range {IQR}: 3.5-6.4] mm2 vs. 4.3 [3.4-5.3] mm2 vs. 6.5 [4.8-8.6] mm2, P<0.001). Plaque burden was not significantly different between TCFA and HP, but was larger in TCFA and HP than in ThCFA (72 [IQR: 66-80] % vs. 75 [67-80] % vs. 62 [54-69] %, P<0.001). Maximum lipid core burden index in 4mm (maxLCBI4mm) was largest in TCFA, followed by HP and ThCFA (493 [IQR: 443-606] vs. 446 [347-520] vs. 231 [161-302], P<0.001). The frequency of lipid rich plaque with maxLCBI4mm >400 was highest in TCFA, followed by HP and ThCFA (89% vs. 60% vs. 7%, P<0.001).</p><p>Conclusions: Based on NIRS-IVUS findings, non-culprit coronary HP in AMI was associated with vulnerable plaque characteristics, but not as much as TCFA.</p>

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