Optical coherence tomography features of angiographic complex and smooth lesions in acute coronary syndromes

The International Journal of Cardiovascular Imaging
Hesham RefaatFilippo Crea

Abstract

Plaque rupture (PR) and superimposed thrombosis have been shown as the most frequent underlying substrate in acute coronary syndromes (ACS). Coronary angiography is a luminogram not able to define in vivo features of the culprit plaques. The aim of the study was to use optical coherence tomography (OCT) to investigate the pathology underlying complex (CL) and non-complex angiographic lesions (NCL). We retrospectively enrolled 107 ACS patients admitted to our institution; 83 with non-ST elevation ACS (NSTE-ACS) and 24 with ST-elevation myocardial infarction. Coronary angiography was performed and culprit lesions were classified according to Ambrose criteria into NCL (n = 47) and CL (n = 60). OCT imaging was then performed to better identify plaque morphology; either PR or intact fibrous cap, the presence of superimposed thrombosis, lipid rich plaque, and thin cap fibroatheroma (TCFA). OCT analysis showed that 58 lesions (54.2%) were classified as PR and 48 lesions (44.9%) were associated with thrombi. Lipid rich plaques were identified in 62 lesions (57.9%). PR, intracoronary thrombi, lipid rich plaques and TCFA were more frequent in CL compared with NCL (71.7 vs 31.9%, 63.3 vs 21.3%, 71.7 vs 40.4% and 46.7 vs 21.3% respectively...Continue Reading

References

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Citations

Feb 8, 2016·Revista Portuguesa De Cardiologia : Orgão Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology·Rui Cruz FerreiraMarco Costa
Apr 18, 2016·The International Journal of Cardiovascular Imaging·Hiram G BezerraNico R L Van de Veire
Oct 29, 2015·European Heart Journal Cardiovascular Imaging·Mario IannacconeFiorenzo Gaita
Nov 5, 2016·Nature Reviews. Cardiology·Gerard PasterkampPeter Libby
Oct 25, 2020·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Hesham Refaat, Ayman Tantawy

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