Clinical significance of healed plaque detected by optical coherence tomography: a 2-year follow-up study
- 12 May 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Journal of Thrombosis and Thrombolysis
- Vol. 50 (4), 895-902
- https://doi.org/10.1007/s11239-020-02076-w
Abstract
Recent studies have shown that healed plaque at the culprit lesion detected by optical coherence tomography (OCT) is a sign of pan-vascular vulnerability and advanced atherosclerosis. However, the clinical significance of healed plaque is unknown. A total of 265 patients who had OCT imaging of a culprit vessel and 2-year clinical follow-up data were included. Patients were stratified based on the presence or absence of a layered plaque phenotype, defined as layers of different optical density by OCT at either culprit or non-culprit lesions. The association between layered plaque and major adverse cardiac events (MACE), defined as cardiac death, acute coronary syndromes (ACS), or revascularization, was studied. Among 265 patients, 96 (36.2%) had the layered plaque phenotype. Layered plaque was more frequently observed in stable angina pectoris patients than in ACS patients (57.8%vs. 25.1%, p < 0.001). The average clinical follow-up period was 672 ± 172 days. Cumulative MACE was significantly higher in patients with layered plaque (p = 0.041), which was primarily driven by the high revascularization rate at 2 years (p = 0.002). Multivariate regression analysis showed that presence of layered plaque and low-density lipoprotein cholesterol levels were independently associated with an increased risk of revascularization (p = 0.026, p = 0.008, respectively). Patients with healed plaque in the culprit vessel had a higher incidence of revascularization, as compared to those without healed plaque, at 2 years.Keywords
This publication has 21 references indexed in Scilit:
- Characteristics and significance of healed plaques in patients with acute coronary syndrome and stable angina: an in vivo OCT and IVUS studyEuroIntervention, 2019
- Healed Culprit Plaques in Patients With Acute Coronary SyndromesJournal of the American College of Cardiology, 2019
- In vivo optical coherence tomography imaging and histopathology of healed coronary plaquesAtherosclerosis, 2018
- Serial 3-Vessel Optical Coherence Tomography and Intravascular Ultrasound Analysis of Changing Morphologies Associated With Lesion Progression in Patients With Stable Angina PectorisCirculation: Cardiovascular Imaging, 2017
- Features of Coronary Plaque in Patients With Metabolic Syndrome and Diabetes Mellitus Assessed by 3-Vessel Optical Coherence TomographyCirculation: Cardiovascular Imaging, 2013
- In Vivo Diagnosis of Plaque Erosion and Calcified Nodule in Patients With Acute Coronary Syndrome by Intravascular Optical Coherence TomographyJournal of the American College of Cardiology, 2013
- Concept of Vulnerable/Unstable PlaqueArteriosclerosis, Thrombosis, and Vascular Biology, 2010
- Healed Plaque Ruptures and Sudden Coronary DeathCirculation, 2001
- Lessons From Sudden Coronary DeathArteriosclerosis, Thrombosis, and Vascular Biology, 2000
- Elucidation off the role of plaque instability and rupture in acute coronary eventsThe American Journal of Cardiology, 1995