The combination assessment of lipid pool and thrombus by optical coherence tomography can predict the filter no-reflow in primary PCI for ST elevated myocardial infarction

Negishi, Yosuke; Ishii, Hideki; Suzuki, Susumu; Aoki, Toshijiro; Iwakawa, Naoki; Kojima, Hiroki; Harada, Kazuhiro; Hirayama, Kenshi; Mitsuda, Takayuki; Sumi, Takuya; Tanaka, Akihito; Ogawa, Yasuhiro; Kawaguchi, Katsuhiro; Murohara, Toyoaki

doi:10.1097/md.0000000000009297

Cited by 6 publications

(4 citation statements)

References 35 publications

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“…The presence of LRP in culprit lesions was reported to lead to in-stent plaque prolapse, incomplete stent apposition and edge dissection 28,31,32) . In addition, the risk of no-reflow and increment of cardiac biomarkers was also higher in patients with LRP 33,34) . In a recent study, patients with plaque erosion were shown to have poor prognosis if their underlying plaque phenotype was lipid rich 3) .…”

Section: Limitationmentioning

confidence: 93%

Lipid Content Distribution and its Clinical Implication in Patients with Acute Myocardial Infarction-Plaque Erosion: Results from the Prospective OCTAMI Study

Li,

Chen,

Zhou

et al. 2024

JAT

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Aims: Plaque erosion (PE) is one of the main plaque phenotypes of acute coronary syndrome (ACS). However, the underlying plaque component and distribution have not been systematically analysed. This study aims to investigate the distribution of lipid and calcium content in culprit lesions assessed by optical coherence tomography (OCT) in patients with PE and explore its relationship with prognosis in a cohort of ST segment elevation myocardial infarction (STEMI) patients. Methods: A prospective cohort of 576 patients with STEMI was enrolled in our study. After exclusion, 152 PE patients with clear underlying plaque components were ultimately analysed. The culprit lesion was divided into the border zone, external erosion zone and erosion site in the longitudinal view. Each pullback of the culprit lesions was assessed by 3 independent investigators frame-by-frame, and the quantity and distribution of lipid and calcium components were recorded. Results: Of the 152 PE patients, lipid and calcium contents were more likely to exist in the external erosion zone than in the other regions. In particular, a high level of lipid content proximal to the erosion site was significantly associated with plaque vulnerability and a higher incidence of MACEs. Conclusion: This study revealed that high level of lipid content in the proximal external erosion zone was related to high-risk plaque characteristics and poor prognosis, which provided a novel method for risk stratification and precise management in patients with plaque erosion.

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Section: Limitationmentioning

confidence: 93%

Lipid Content Distribution and its Clinical Implication in Patients with Acute Myocardial Infarction-Plaque Erosion: Results from the Prospective OCTAMI Study

Li,

Chen,

Zhou

et al. 2024

JAT

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“…Lipid index was estimated by multiplying the lipid arc average with the length calculated longitudinally of the lipid-rich component. 20 …”

Section: Methodsmentioning

confidence: 99%

Gender-based in vivo comparison of culprit plaque characteristics and plaque microstructures using optical coherence tomography in acute coronary syndrome

Prasad

Kaur

et al. 2021

J Cardiovasc Thorac Res

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Introduction: Women perform worse after acute coronary syndrome (ACS) than men. The reason for these differences is unclear. The aim was to ascertain gender differences in the culprit plaque characteristics in ACS. Methods:Patients with ACS undergoing percutaneous coronary intervention for the culprit vessel underwent optical coherence tomography (OCT) imaging. Culprit plaque was identified as lipid rich,fibrous, and calcific plaque. Mechanisms underlying ACS are classified as plaque rupture, erosion,or calcified nodule. A lipid rich plaque along with thin-cap fibroatheroma (TCFA) was a vulnerable plaque. Plaque microstructures including cholesterol crystals, macrophages, and microvessels were noted. Results: A total of 52 patients were enrolled (men=29 and women=23). Baseline demographic features were similar in both the groups except men largely were current smokers (P<0.001). Plaque morphology,men vs. women: lipid rich 88.0% vs. 90.5%; fibrous 4% vs 0%; calcific 8.0% vs. 9.5% (P = 0.64). Of the ACS mechanisms in males versus females; plaque rupture (76.9 % vs. 50 %), plaque erosion (15.4 % vs.40 %) and calcified nodule (7.7 % vs. 10 %) was noted (P = 0.139). Fibrous cap thickness was (50.19 ±11.17 vs. 49.00 ± 10.71 mm, P = 0.71) and thin-cap fibroatheroma (96.2% vs. 95.0%, P = 1.0) in men and women respectively. Likewise no significant difference in presence of macrophages (42.3 % vs. 30%, P = 0.76), microvessels (73.1% vs. 60 %, P = 0.52) and cholesterol crystals (92.3% vs. 80%, P = 0.38). Conclusion: No significant gender-based in-vivo differences could be discerned in ACS patients’ culprit plaques morphology, characteristics, and underlying mechanisms.

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“…As OCT exhibits limited tissue penetration and is constrained by attenuation effects, however, thrombus images can become unclear, particularly for red thrombi, thus preventing thorough quantitative analyses of thrombi or underlying plaques, especially in the presence of lipid plaques or thrombus. Besides, OCT is not suited to visualization as far as the outer membrane ( Figure 2 ) ( 46 ). Kaivosoja et al ( 47 ) thus designed a novel computer image analysis-based approach to assessing thrombus morphology in OCT images.…”

Section: Non-molecular Imaging Of Thrombosismentioning

confidence: 99%

Molecular Imaging and Non-molecular Imaging of Atherosclerotic Plaque Thrombosis

Guo

et al. 2021

Front. Cardiovasc. Med.

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Thrombosis in the context of atherosclerosis typically results in life-threatening consequences, including acute coronary events and ischemic stroke. As such, early detection and treatment of thrombosis in atherosclerosis patients is essential. Clinical diagnosis of thrombosis in these patients is typically based upon a combination of imaging approaches. However, conventional imaging modalities primarily focus on assessing the anatomical structure and physiological function, severely constraining their ability to detect early thrombus formation or the processes underlying such pathology. Recently, however, novel molecular and non-molecular imaging strategies have been developed to assess thrombus composition and activity at the molecular and cellular levels more accurately. These approaches have been successfully used to markedly reduce rates of atherothrombotic events in patients suffering from acute coronary syndrome (ACS) by facilitating simultaneous diagnosis and personalized treatment of thrombosis. Moreover, these modalities allow monitoring of plaque condition for preventing plaque rupture and associated adverse cardiovascular events in such patients. Sustained developments in molecular and non-molecular imaging technologies have enabled the increasingly specific and sensitive diagnosis of atherothrombosis in animal studies and clinical settings, making these technologies invaluable to patients' health in the future. In the present review, we discuss current progress regarding the non-molecular and molecular imaging of thrombosis in different animal studies and atherosclerotic patients.

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The combination assessment of lipid pool and thrombus by optical coherence tomography can predict the filter no-reflow in primary PCI for ST elevated myocardial infarction

Cited by 6 publications

References 35 publications

Lipid Content Distribution and its Clinical Implication in Patients with Acute Myocardial Infarction-Plaque Erosion: Results from the Prospective OCTAMI Study

Lipid Content Distribution and its Clinical Implication in Patients with Acute Myocardial Infarction-Plaque Erosion: Results from the Prospective OCTAMI Study

Gender-based in vivo comparison of culprit plaque characteristics and plaque microstructures using optical coherence tomography in acute coronary syndrome

Molecular Imaging and Non-molecular Imaging of Atherosclerotic Plaque Thrombosis

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