PMID- 27482258
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160802
LR  - 20201001
IS  - 1738-5520 (Print)
IS  - 1738-5555 (Electronic)
IS  - 1738-5520 (Linking)
VI  - 46
IP  - 4
DP  - 2016 Jul
TI  - Multimodality Intravascular Imaging Assessment of Plaque Erosion versus Plaque 
      Rupture in Patients with Acute Coronary Syndrome.
PG  - 499-506
LID - 10.4070/kcj.2016.46.4.499 [doi]
AB  - BACKGROUND AND OBJECTIVES: We assessed plaque erosion of culprit lesions in 
      patients with acute coronary syndrome in real world practice. SUBJECTS AND 
      METHODS: Culprit lesion plaque rupture or plaque erosion was diagnosed with 
      optical coherence tomography (OCT). Intravascular ultrasound (IVUS) was used to 
      determine arterial remodeling. Positive remodeling was defined as a remodeling 
      index (lesion/reference EEM [external elastic membrane area) >1.05. RESULTS: A 
      total of 90 patients who had plaque rupture showing fibrous-cap discontinuity and 
      ruptured cavity were enrolled. 36 patients showed definite OCT-plaque erosion, 
      while 7 patients had probable OCT-plaque erosion. Overall, 26% (11/43) of 
      definite/probable plaque erosion had non-ST elevation myocardial infarction 
      (NSTEMI) while 35% (15/43) had ST elevation myocardial infarction (STEMI). 
      Conversely, 14.5% (13/90) of plaque rupture had NSTEMI while 71% (64/90) had 
      STEMI (p<0.0001). Among plaque erosion, white thrombus was seen in 55.8% (24/43) 
      of patients and red thrombus in 27.9% (12/43) of patients. Compared to plaque 
      erosion, plaque rupture more often showed positive remodeling (p=0.003) with a 
      larger necrotic core area examined by virtual histology (VH)-IVUS, while negative 
      remodeling was prominent in plaque erosion. Overall, 65% 28/43 of plaque erosions 
      were located in the proximal 30 mm of a culprit vessel-similar to plaque ruptures 
      (72%, 65/90, p=0.29). CONCLUSION: Although most of plaque erosions show nearly 
      normal coronary angiogram, modest plaque burden with negative remodeling and an 
      uncommon fibroatheroma might be the nature of plaque erosion. Multimodality 
      intravascular imaging with OCT and VH-IVUS showed fundamentally different 
      pathoanatomic substrates underlying plaque rupture and erosion.
FAU - Kwon, Jee Eun
AU  - Kwon JE
AD  - Heart Research Institute, Cardiovascular-Arrhythmia Center, College of Medicine, 
      Chung-Ang University Hospital, Seoul, Korea.
FAU - Lee, Wang Soo
AU  - Lee WS
AD  - Heart Research Institute, Cardiovascular-Arrhythmia Center, College of Medicine, 
      Chung-Ang University Hospital, Seoul, Korea.
FAU - Mintz, Gary S
AU  - Mintz GS
AD  - Cardiovascular Research Foundation, New York, USA.
FAU - Hong, Young Joon
AU  - Hong YJ
AD  - Chonnam National University Hospital, Gwangju, Korea.
FAU - Lee, Sung Yun
AU  - Lee SY
AD  - Inje University Ilsan Paik Hospital, Koyang, Korea.
FAU - Kim, Ki Seok
AU  - Kim KS
AD  - Jeju National University Hospital, Jeju, Korea.
FAU - Hahn, Joo-Yong
AU  - Hahn JY
AD  - Samsung Medical Center, Seoul, Korea.
FAU - Kumar, Kaup Sharath
AU  - Kumar KS
AD  - Heart Research Institute, Cardiovascular-Arrhythmia Center, College of Medicine, 
      Chung-Ang University Hospital, Seoul, Korea.
FAU - Won, Hoyoun
AU  - Won H
AD  - Heart Research Institute, Cardiovascular-Arrhythmia Center, College of Medicine, 
      Chung-Ang University Hospital, Seoul, Korea.
FAU - Hyeon, Seong Hyeop
AU  - Hyeon SH
AD  - Heart Research Institute, Cardiovascular-Arrhythmia Center, College of Medicine, 
      Chung-Ang University Hospital, Seoul, Korea.
FAU - Shin, Seung Yong
AU  - Shin SY
AD  - Heart Research Institute, Cardiovascular-Arrhythmia Center, College of Medicine, 
      Chung-Ang University Hospital, Seoul, Korea.
FAU - Lee, Kwang Je
AU  - Lee KJ
AD  - Heart Research Institute, Cardiovascular-Arrhythmia Center, College of Medicine, 
      Chung-Ang University Hospital, Seoul, Korea.
FAU - Kim, Tae Ho
AU  - Kim TH
AD  - Heart Research Institute, Cardiovascular-Arrhythmia Center, College of Medicine, 
      Chung-Ang University Hospital, Seoul, Korea.
FAU - Kim, Chee Jeong
AU  - Kim CJ
AD  - Heart Research Institute, Cardiovascular-Arrhythmia Center, College of Medicine, 
      Chung-Ang University Hospital, Seoul, Korea.
FAU - Kim, Sang Wook
AU  - Kim SW
AD  - Heart Research Institute, Cardiovascular-Arrhythmia Center, College of Medicine, 
      Chung-Ang University Hospital, Seoul, Korea.
LA  - eng
PT  - Journal Article
DEP - 20160721
PL  - Korea (South)
TA  - Korean Circ J
JT  - Korean circulation journal
JID - 101247141
PMC - PMC4965428
OTO - NOTNLM
OT  - Acute coronary syndrome
OT  - Atherosclerotic plaque
OT  - Optical coherence tomography
COIS- The authors have no financial conflicts of interest.
EDAT- 2016/08/03 06:00
MHDA- 2016/08/03 06:01
PMCR- 2016/07/01
CRDT- 2016/08/03 06:00
PHST- 2015/08/11 00:00 [received]
PHST- 2015/11/12 00:00 [revised]
PHST- 2015/12/24 00:00 [accepted]
PHST- 2016/08/03 06:00 [entrez]
PHST- 2016/08/03 06:00 [pubmed]
PHST- 2016/08/03 06:01 [medline]
PHST- 2016/07/01 00:00 [pmc-release]
AID - 10.4070/kcj.2016.46.4.499 [doi]
PST - ppublish
SO  - Korean Circ J. 2016 Jul;46(4):499-506. doi: 10.4070/kcj.2016.46.4.499. Epub 2016 
      Jul 21.