Pathology of Acute Coronary Syndrome, Assessed Using Optical Coherence Tomography
Keywords:
Plaque rupture, Plaque erosion, Calcified nodule, Optical coherence tomography, Acute coronary syndromeAbstract
Objectives: We aimed to characterize the pathology of patients with acute coronary syndrome (ACS) using optical coherence tomography (OCT).
Background: OCT is a new, high-resolution intravascular imaging modality that is useful for the assessment of the morphology of ACS lesions.
Methods: We studied 22 patients with ACS using OCT imaging. The pathological features of the disease were classified as plaque rupture, plaque erosion, and calcified nodule.
Results: The incidences of plaque rupture, plaque erosion, and calcified nodule were 73%, 9%, and 9%, respectively. Participants with plaque rupture tended to be younger than those with the other types of lesions (65.7 ± 9.4, 72.0 ± 9.9, and 80.0 ± 8.5 years, respectively; p=0.13). Fibrous plaque tended to be more prevalent than plaque erosion (75%, 100%, and 0%, respectively; p=0.15). The serum creatinine concentration of participants with calcified nodule was higher than that of participants with plaque rupture (1.2 ± 0 vs. 1.0 ± 0.2; p=0.049). The mean minimum luminal diameter (MLD) was highest in participants with calcified nodule and was significantly higher than in participants with plaque rupture (1.5 ± 0.5 vs. 1.0 ± 0.2; p=0.047).
Conclusions: Plaque rupture was the most common lesion, being present in 73% of the patients with ACS, and plaque erosion tended to be associated with the lowest mean luminal area of the three types of lesions. In addition, calcified nodules were common in older patients and were associated with a higher creatinine concentration and MLD than plaque rupture.
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