The aim of this study was to investigate the distribution and frequency of thin-capped
fibroatheromas (TCFAs) within the entire length of culprit coronary arteries in patients
with acute coronary syndrome. Our population was drawn from 43 consecutive patients
with acute coronary syndrome (with or without ST-segment elevation) who underwent
optical coherence tomography to visualize the entire culprit coronary artery using
a nonocclusive optical coherence tomographic technique. Patients were categorized
divided into a TCFA group or a no-TCFA group on the basis of the optical coherence
tomographic findings. There were no differences in baseline characteristics or angiographic
findings between the 2 groups. High-sensitive C-reactive protein in the TCFA group
was significantly higher than in the no-TCFA group (median 3.3 mg/L, interquartile
3.1, vs 1.7 mg/L, interquartile 2.2, p = 0.03). Plaque rupture was found in 28 patients
(65%) and multiple plaque ruptures in 5 patients (12%). Optical coherence tomogram
revealed 21 TCFAs in 18 patients (42%). Multiple TCFAs were found in the same vessel
in 3 patients (7%). The distribution of TCFAs in the right coronary arteries of our
subject population was relatively even (proximal 2 [12%], mid 5 [29%], distal 3 [18%],
p = 0.42), whereas TCFAs in the left anterior descending artery were common in proximal
sites (proximal 6 [27%], mid 2 [9%], distal 0, p = 0.018). In conclusion, the use
of optical coherence tomography to look for TCFAs and identify their distribution
when combined with C-reactive protein may contribute to forming a strategy for preventing
impending coronary events.
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References
- Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography: comparison with intravascular ultrasound.J Am Coll Cardiol. 2002; 39: 604-609
- Optical coherence tomography for optical biopsy.Circulation. 1996; 93: 1206-1213
- Assessment of coronary intima-media thickness by optical coherence tomography: comparison with intravascular ultrasound.Circ J. 2005; 69: 903-907
- Visualization of neointima formation by optical coherence tomography.Int Heart J. 2005; 46: 1133-1136
- Assessment of coronary arterial plaque by optical coherence tomography.Am J Cardiol. 2006; 97: 1172-1175
- In vivo characterization of coronary atherosclerotic plaque by use of optical coherence tomography.Circulation. 2005; 111: 1551-1555
- Characterization of human atherosclerosis by optical coherence tomography.Circulation. 2002; 106: 1640-1645
- Protocol for the Bypass Angioplasty Revascularization Investigation.Circulation. 1991; 84 (V–1.)
- Coronary artery spatial distribution of acute myocardial infarction occlusions.Circulation. 2004; 110: 278-284
- Frequency and distribution of thin-cap fibroatheroma and ruptured plaques in human coronary arteries: a pathologic study.J Am Coll Cardiol. 2007; 50: 940-949
- Site of intimal rupture or erosion of thrombosed coronary atherosclerotic plaques is characterized by an inflammatory process irrespective of the dominant plaque morphology.Circulation. 1994; 89: 36-44
- Sudden coronary death Frequency of active coronary lesions, inactive coronary lesions, and myocardial infarction.Circulation. 1995; 92: 1701-1709
- Assessment of culprit lesion morphology in acute myocardial infarction: ability of optical coherence tomography compared with intravascular ultrasound and coronary angioscopy.J Am Coll Cardiol. 2007; 50: 933-939
- Multiple plaque rupture and C-reactive protein in acute myocardial infarction.J Am Coll Cardiol. 2005; 45: 1594-1599
- Coronary plaque morphology and frequency of ulceration distant from culprit lesions in patients with unstable and stable presentation.Arterioscler Thromb Vasc Biol. 2003; 23: 1895-1900
- Intravascular ultrasound analysis of infarct-related and non–infarct-related arteries in patients who presented with an acute myocardial infarction.Circulation. 2003; 107: 2889-2893
- Early statin treatment following acute myocardial infarction and 1-year survival.JAMA. 2001; 285: 430-436
- Does proximal location of culprit lesion confer worse prognosis in patients undergoing primary percutaneous coronary intervention for ST elevation myocardial infarction?.J Interv Cardiol. 2006; 19: 285-294
- No-reflow phenomenon and lesion morphology in patients with acute myocardial infarction.Circulation. 2002; 105: 2148-2152
Article Info
Publication History
Published online: August 04, 2008
Accepted:
May 27,
2008
Received in revised form:
May 27,
2008
Received:
February 24,
2008
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
