Pancoronary plaque vulnerability in patients with acute coronary syndrome and ruptured culprit plaque

A 3-vessel optical coherence tomography study

Rocco Vergallo, Xuefeng Ren, Taishi Yonetsu, Koji Kato, Shiro Uemura, Bo Yu, Haibo Jia, Farhad Abtahian, Aaron D. Aguirre, Jinwei Tian, Sining Hu, Tsunenari Soeda, Hang Lee, Iris McNulty, Seung Jung Park, Yangsoo Jang, Abhiram Prasad, Stephen Lee, Shaosong Zhang, Italo Porto & 3 others Luigi M. Biasucci, Filippo Crea, Ik Kyung Jang

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Background Recent studies described different clinical and underlying plaque characteristics between patients with and without plaque rupture presenting with acute coronary syndrome (ACS). In light of the systemic nature of atherosclerosis, we hypothesized that nonculprit plaques might also express different morphological features in these 2 groups of patients. Methods Thirty-eight patients with ACS who underwent 3-vessel optical coherence tomography imaging were identified from the Massachusetts General Hospital Optical Coherence Tomography Registry. Based on culprit plaque morphology, the study population was divided into 2 groups: patients with plaque rupture at the culprit lesion (group 1) and patients with nonruptured plaque at the culprit lesion (group 2). Prevalence and features of nonculprit plaques were compared between the 2 groups. Results A total of 118 nonculprit plaques were analyzed. Patients in group 1 (n = 17) had nonculprit plaques with higher prevalence of thin-cap fibroatheroma (52.9% vs 19.0%, P =.029) and disruption (35.3% vs 4.8%, P =.016) compared with patients in group 2 (n = 21). Nonculprit plaques in group 1 showed wider maximum lipid arc (198.9 ± 41.7 vs 170.2 ± 41.9, P =.003), greater lipid length (7.8 ± 4.4 mm vs 5.1 ± 2.4 mm, P =.003), higher lipid index (1196.9 ± 700.5 vs 747.7 ± 377.3, P =.001), and thinner fibrous cap (107.0 ± 56.5 μm vs 137.3 ± 69.8 μm, P =.035) compared with those in group 2. Conclusions The present study showed distinctive features of nonculprit plaques between patients with ACS caused by plaque rupture and patients with ACS caused by nonruptured plaques. Patients with plaque rupture had increased pancoronary vulnerability in nonculprit plaques, suggesting that a more aggressive treatment paradigm aiming at the stabilization of vulnerable plaques may offer additional benefit to these patients.

Original languageEnglish (US)
Pages (from-to)59-67
Number of pages9
JournalAmerican Heart Journal
Volume167
Issue number1
DOIs
StatePublished - Jan 2014

Fingerprint

Optical Coherence Tomography
Acute Coronary Syndrome
Rupture
Lipids
Atherosclerotic Plaques
General Hospitals
Registries
Atherosclerosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Pancoronary plaque vulnerability in patients with acute coronary syndrome and ruptured culprit plaque : A 3-vessel optical coherence tomography study. / Vergallo, Rocco; Ren, Xuefeng; Yonetsu, Taishi; Kato, Koji; Uemura, Shiro; Yu, Bo; Jia, Haibo; Abtahian, Farhad; Aguirre, Aaron D.; Tian, Jinwei; Hu, Sining; Soeda, Tsunenari; Lee, Hang; McNulty, Iris; Park, Seung Jung; Jang, Yangsoo; Prasad, Abhiram; Lee, Stephen; Zhang, Shaosong; Porto, Italo; Biasucci, Luigi M.; Crea, Filippo; Jang, Ik Kyung.

In: American Heart Journal, Vol. 167, No. 1, 01.2014, p. 59-67.

Research output: Contribution to journalArticle

Vergallo, R, Ren, X, Yonetsu, T, Kato, K, Uemura, S, Yu, B, Jia, H, Abtahian, F, Aguirre, AD, Tian, J, Hu, S, Soeda, T, Lee, H, McNulty, I, Park, SJ, Jang, Y, Prasad, A, Lee, S, Zhang, S, Porto, I, Biasucci, LM, Crea, F & Jang, IK 2014, 'Pancoronary plaque vulnerability in patients with acute coronary syndrome and ruptured culprit plaque: A 3-vessel optical coherence tomography study', American Heart Journal, vol. 167, no. 1, pp. 59-67. https://doi.org/10.1016/j.ahj.2013.10.011
Vergallo, Rocco ; Ren, Xuefeng ; Yonetsu, Taishi ; Kato, Koji ; Uemura, Shiro ; Yu, Bo ; Jia, Haibo ; Abtahian, Farhad ; Aguirre, Aaron D. ; Tian, Jinwei ; Hu, Sining ; Soeda, Tsunenari ; Lee, Hang ; McNulty, Iris ; Park, Seung Jung ; Jang, Yangsoo ; Prasad, Abhiram ; Lee, Stephen ; Zhang, Shaosong ; Porto, Italo ; Biasucci, Luigi M. ; Crea, Filippo ; Jang, Ik Kyung. / Pancoronary plaque vulnerability in patients with acute coronary syndrome and ruptured culprit plaque : A 3-vessel optical coherence tomography study. In: American Heart Journal. 2014 ; Vol. 167, No. 1. pp. 59-67.
@article{d09f3287e83a413f9ebde25e765572db,
title = "Pancoronary plaque vulnerability in patients with acute coronary syndrome and ruptured culprit plaque: A 3-vessel optical coherence tomography study",
abstract = "Background Recent studies described different clinical and underlying plaque characteristics between patients with and without plaque rupture presenting with acute coronary syndrome (ACS). In light of the systemic nature of atherosclerosis, we hypothesized that nonculprit plaques might also express different morphological features in these 2 groups of patients. Methods Thirty-eight patients with ACS who underwent 3-vessel optical coherence tomography imaging were identified from the Massachusetts General Hospital Optical Coherence Tomography Registry. Based on culprit plaque morphology, the study population was divided into 2 groups: patients with plaque rupture at the culprit lesion (group 1) and patients with nonruptured plaque at the culprit lesion (group 2). Prevalence and features of nonculprit plaques were compared between the 2 groups. Results A total of 118 nonculprit plaques were analyzed. Patients in group 1 (n = 17) had nonculprit plaques with higher prevalence of thin-cap fibroatheroma (52.9{\%} vs 19.0{\%}, P =.029) and disruption (35.3{\%} vs 4.8{\%}, P =.016) compared with patients in group 2 (n = 21). Nonculprit plaques in group 1 showed wider maximum lipid arc (198.9 ± 41.7 vs 170.2 ± 41.9, P =.003), greater lipid length (7.8 ± 4.4 mm vs 5.1 ± 2.4 mm, P =.003), higher lipid index (1196.9 ± 700.5 vs 747.7 ± 377.3, P =.001), and thinner fibrous cap (107.0 ± 56.5 μm vs 137.3 ± 69.8 μm, P =.035) compared with those in group 2. Conclusions The present study showed distinctive features of nonculprit plaques between patients with ACS caused by plaque rupture and patients with ACS caused by nonruptured plaques. Patients with plaque rupture had increased pancoronary vulnerability in nonculprit plaques, suggesting that a more aggressive treatment paradigm aiming at the stabilization of vulnerable plaques may offer additional benefit to these patients.",
author = "Rocco Vergallo and Xuefeng Ren and Taishi Yonetsu and Koji Kato and Shiro Uemura and Bo Yu and Haibo Jia and Farhad Abtahian and Aguirre, {Aaron D.} and Jinwei Tian and Sining Hu and Tsunenari Soeda and Hang Lee and Iris McNulty and Park, {Seung Jung} and Yangsoo Jang and Abhiram Prasad and Stephen Lee and Shaosong Zhang and Italo Porto and Biasucci, {Luigi M.} and Filippo Crea and Jang, {Ik Kyung}",
year = "2014",
month = "1",
doi = "10.1016/j.ahj.2013.10.011",
language = "English (US)",
volume = "167",
pages = "59--67",
journal = "American Heart Journal",
issn = "0002-8703",
publisher = "Mosby Inc.",
number = "1",

}

TY - JOUR

T1 - Pancoronary plaque vulnerability in patients with acute coronary syndrome and ruptured culprit plaque

T2 - A 3-vessel optical coherence tomography study

AU - Vergallo, Rocco

AU - Ren, Xuefeng

AU - Yonetsu, Taishi

AU - Kato, Koji

AU - Uemura, Shiro

AU - Yu, Bo

AU - Jia, Haibo

AU - Abtahian, Farhad

AU - Aguirre, Aaron D.

AU - Tian, Jinwei

AU - Hu, Sining

AU - Soeda, Tsunenari

AU - Lee, Hang

AU - McNulty, Iris

AU - Park, Seung Jung

AU - Jang, Yangsoo

AU - Prasad, Abhiram

AU - Lee, Stephen

AU - Zhang, Shaosong

AU - Porto, Italo

AU - Biasucci, Luigi M.

AU - Crea, Filippo

AU - Jang, Ik Kyung

PY - 2014/1

Y1 - 2014/1

N2 - Background Recent studies described different clinical and underlying plaque characteristics between patients with and without plaque rupture presenting with acute coronary syndrome (ACS). In light of the systemic nature of atherosclerosis, we hypothesized that nonculprit plaques might also express different morphological features in these 2 groups of patients. Methods Thirty-eight patients with ACS who underwent 3-vessel optical coherence tomography imaging were identified from the Massachusetts General Hospital Optical Coherence Tomography Registry. Based on culprit plaque morphology, the study population was divided into 2 groups: patients with plaque rupture at the culprit lesion (group 1) and patients with nonruptured plaque at the culprit lesion (group 2). Prevalence and features of nonculprit plaques were compared between the 2 groups. Results A total of 118 nonculprit plaques were analyzed. Patients in group 1 (n = 17) had nonculprit plaques with higher prevalence of thin-cap fibroatheroma (52.9% vs 19.0%, P =.029) and disruption (35.3% vs 4.8%, P =.016) compared with patients in group 2 (n = 21). Nonculprit plaques in group 1 showed wider maximum lipid arc (198.9 ± 41.7 vs 170.2 ± 41.9, P =.003), greater lipid length (7.8 ± 4.4 mm vs 5.1 ± 2.4 mm, P =.003), higher lipid index (1196.9 ± 700.5 vs 747.7 ± 377.3, P =.001), and thinner fibrous cap (107.0 ± 56.5 μm vs 137.3 ± 69.8 μm, P =.035) compared with those in group 2. Conclusions The present study showed distinctive features of nonculprit plaques between patients with ACS caused by plaque rupture and patients with ACS caused by nonruptured plaques. Patients with plaque rupture had increased pancoronary vulnerability in nonculprit plaques, suggesting that a more aggressive treatment paradigm aiming at the stabilization of vulnerable plaques may offer additional benefit to these patients.

AB - Background Recent studies described different clinical and underlying plaque characteristics between patients with and without plaque rupture presenting with acute coronary syndrome (ACS). In light of the systemic nature of atherosclerosis, we hypothesized that nonculprit plaques might also express different morphological features in these 2 groups of patients. Methods Thirty-eight patients with ACS who underwent 3-vessel optical coherence tomography imaging were identified from the Massachusetts General Hospital Optical Coherence Tomography Registry. Based on culprit plaque morphology, the study population was divided into 2 groups: patients with plaque rupture at the culprit lesion (group 1) and patients with nonruptured plaque at the culprit lesion (group 2). Prevalence and features of nonculprit plaques were compared between the 2 groups. Results A total of 118 nonculprit plaques were analyzed. Patients in group 1 (n = 17) had nonculprit plaques with higher prevalence of thin-cap fibroatheroma (52.9% vs 19.0%, P =.029) and disruption (35.3% vs 4.8%, P =.016) compared with patients in group 2 (n = 21). Nonculprit plaques in group 1 showed wider maximum lipid arc (198.9 ± 41.7 vs 170.2 ± 41.9, P =.003), greater lipid length (7.8 ± 4.4 mm vs 5.1 ± 2.4 mm, P =.003), higher lipid index (1196.9 ± 700.5 vs 747.7 ± 377.3, P =.001), and thinner fibrous cap (107.0 ± 56.5 μm vs 137.3 ± 69.8 μm, P =.035) compared with those in group 2. Conclusions The present study showed distinctive features of nonculprit plaques between patients with ACS caused by plaque rupture and patients with ACS caused by nonruptured plaques. Patients with plaque rupture had increased pancoronary vulnerability in nonculprit plaques, suggesting that a more aggressive treatment paradigm aiming at the stabilization of vulnerable plaques may offer additional benefit to these patients.

UR - http://www.scopus.com/inward/record.url?scp=84890130307&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84890130307&partnerID=8YFLogxK

U2 - 10.1016/j.ahj.2013.10.011

DO - 10.1016/j.ahj.2013.10.011

M3 - Article

VL - 167

SP - 59

EP - 67

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

IS - 1

ER -