NIRS-IVUS Assessment of OCT-Derived Healed Coronary Plaques.

IF 3 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of atherosclerosis and thrombosis Pub Date : 2024-09-07 DOI:10.5551/jat.64781

Kosei Terada, Takashi Kubo, Amir Kh M Khalifa, Wei-Ting Wang, Suwako Fujita, Ryan D Madder

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引用次数: 0

Abstract

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).

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.

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 (maxLCBI_4mm) 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 maxLCBI_4mm ＞400 was highest in TCFA, followed by HP and ThCFA (89% vs. 60% vs. 7%, P＜0.001).

Conclusions: Based on NIRS-IVUS findings, non-culprit coronary HP in AMI was associated with vulnerable plaque characteristics, but not as much as TCFA.

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对 OCT 导出的愈合冠状动脉斑块进行 NIRS-IVUS 评估。

目的：愈合斑块（HP）与斑块快速生长和管腔狭窄有关。薄帽纤维血管瘤（TCFA）被认为是斑块破裂的前兆病变。本研究旨在使用近红外光谱血管内超声（NIRS-IVUS）比较光学相干断层扫描（OCT）得出的 HP、TCFA 和厚盖纤维斑块（ThCFA）的脂质大小：本研究纳入了173名接受经皮冠状动脉介入治疗的急性心肌梗死（AMI）患者。通过 OCT 和 NIRS-IVUS 对血管造影中度狭窄的非冠状动脉病变进行评估：结果：TCFA、HP 和 ThCFA 的发生率分别为 35（20%）、53（30%）和 85（49%）。TCFA和HP的最小管腔面积无明显差异，但TCFA和HP的最小管腔面积小于ThCFA（4.6 [四分位间范围{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）。TCFA和HP的斑块负荷无明显差异，但TCFA和HP的斑块负荷大于ThCFA（72 [IQR: 66-80] % vs. 75 [67-80] % vs. 62 [54-69] %，P＜0.001）。TCFA 的 4mm 最大脂质核心负荷指数（maxLCBI4mm）最大，其次是 HP 和 ThCFA（493 [IQR: 443-606] vs. 446 [347-520] vs. 231 [161-302]，P＜0.001）。在TCFA中，maxLCBI4mm＞400的富脂斑块频率最高，其次是HP和ThCFA（89% vs. 60% vs. 7%，P＜0.001）：结论：根据 NIRS-IVUS 的研究结果，AMI 非冠状动脉 HP 与易损斑块特征相关，但不如 TCFA 相关。

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