PMID- 24953494 OWN - NLM STAT- MEDLINE DCOM- 20150330 LR - 20161125 IS - 1879-1484 (Electronic) IS - 0021-9150 (Linking) VI - 235 IP - 2 DP - 2014 Aug TI - Difference of ruptured plaque morphology between asymptomatic coronary artery disease and non-ST elevation acute coronary syndrome patients: an optical coherence tomography study. PG - 532-7 LID - S0021-9150(14)01170-8 [pii] LID - 10.1016/j.atherosclerosis.2014.05.920 [doi] AB - BACKGROUND: Autopsy studies have reported that rupture of a thin-cap fibroatheroma and subsequent thrombus formation is the major mechanism leading to acute coronary syndrome (ACS). However, it is not clear why only some plaque ruptures lead to ACS. Optical coherence tomography (OCT) is a high-resolution imaging modality which is capable of investigating detailed coronary plaque morphology in vivo. The objective of this study was to determine whether ruptured plaque morphology assessed by OCT differs between asymptomatic coronary artery disease (CAD) and non-ST elevation acute coronary syndrome (NSTEACS). METHODS: We examined ruptured plaque morphology using OCT in 80 patients, 33 with asymptomatic CAD and 47 with NSTEACS. RESULTS: The frequency of lipid-rich plaque and intracoronary thrombus was significantly lower in asymptomatic CAD than in NSTEACS (61% vs. 85%, p = 0.013 and 9% vs. 83%, p < 0.001, respectively). Although maximal ruptured cavity cross-sectional area (CSA) was similar in both groups, lumen area at the rupture site and minimal lumen area were significantly larger in asymptomatic CAD than in NSTEACS (3.78 +/- 1.50 mm(2) vs. 2.70 +/- 1.55 mm(2), p = 0.003 and 2.75 +/- 0.99 mm(2) vs. 1.72 +/- 0.90 mm(2), p < 0.001, respectively). CONCLUSIONS: OCT revealed that the morphology of ruptured plaques differs between asymptomatic CAD and NSTEACS in terms of lumen area and the frequency of lipid-rich plaques and thrombi. These morphological features may be associated with the clinical presentation of CAD. CI - Copyright (c) 2014 Elsevier Ireland Ltd. All rights reserved. FAU - Shimamura, Kunihiro AU - Shimamura K AD - Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan. FAU - Ino, Yasushi AU - Ino Y AD - Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan. Electronic address: yasushi@wakayama-med.ac.jp. FAU - Kubo, Takashi AU - Kubo T AD - Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan. FAU - Nishiguchi, Tsuyoshi AU - Nishiguchi T AD - Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan. FAU - Tanimoto, Takashi AU - Tanimoto T AD - Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan. FAU - Ozaki, Yuichi AU - Ozaki Y AD - Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan. FAU - Satogami, Keisuke AU - Satogami K AD - Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan. FAU - Orii, Makoto AU - Orii M AD - Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan. FAU - Shiono, Yasutsugu AU - Shiono Y AD - Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan. FAU - Komukai, Kenichi AU - Komukai K AD - Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan. FAU - Yamano, Takashi AU - Yamano T AD - Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan. FAU - Matsuo, Yoshiki AU - Matsuo Y AD - Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan. FAU - Kitabata, Hironori AU - Kitabata H AD - Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan. FAU - Yamaguchi, Tomoyuki AU - Yamaguchi T AD - Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan. FAU - Hirata, Kumiko AU - Hirata K AD - Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan. FAU - Tanaka, Atsushi AU - Tanaka A AD - Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan. FAU - Imanishi, Toshio AU - Imanishi T AD - Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan. FAU - Akasaka, Takashi AU - Akasaka T AD - Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan. LA - eng PT - Journal Article DEP - 20140605 PL - Ireland TA - Atherosclerosis JT - Atherosclerosis JID - 0242543 SB - IM MH - Acute Coronary Syndrome/diagnostic imaging/*etiology MH - Aged MH - Coronary Artery Disease/diagnostic imaging/pathology MH - Female MH - Humans MH - Male MH - Middle Aged MH - Plaque, Atherosclerotic/*diagnostic imaging/pathology MH - Rupture, Spontaneous MH - Tomography, Optical Coherence/methods MH - Ultrasonography OTO - NOTNLM OT - Non-ST elevation acute coronary syndrome OT - Optical coherence tomography OT - Silent plaque rupture EDAT- 2014/06/24 06:00 MHDA- 2015/03/31 06:00 CRDT- 2014/06/24 06:00 PHST- 2013/11/14 00:00 [received] PHST- 2014/04/29 00:00 [revised] PHST- 2014/05/03 00:00 [accepted] PHST- 2014/06/24 06:00 [entrez] PHST- 2014/06/24 06:00 [pubmed] PHST- 2015/03/31 06:00 [medline] AID - S0021-9150(14)01170-8 [pii] AID - 10.1016/j.atherosclerosis.2014.05.920 [doi] PST - ppublish SO - Atherosclerosis. 2014 Aug;235(2):532-7. doi: 10.1016/j.atherosclerosis.2014.05.920. Epub 2014 Jun 5.