OBJECTIVES: The aim of this study was to investigate the difference of culprit lesion morphologies assessed by optical coherence tomography (OCT) between ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndrome (NSTEACS). BACKGROUND: Autopsy studies have reported that rupture of a thin-cap fibroatheroma and subsequent thrombus formation is the most important mechanism leading to acute coronary syndrome (ACS). Optical coherence tomography is a high-resolution imaging modality that is capable of investigating detailed coronary plaque morphology in vivo. METHODS: We examined the culprit lesion morphologies by OCT in 89 consecutive patients with acute coronary syndrome (STEMI = 40; NSTEACS = 49). RESULTS: The incidence of plaque rupture, thin-cap fibroatheroma, and red thrombus was significantly higher in STEMI compared with NSTEACS (70% vs. 47%, p = 0.033, 78% vs. 49%, p = 0.008, and 78% vs. 27%, p < 0.001, respectively). Although the lumen area at the site of plaque rupture was similar in the both groups (2.44 ± 1.34 mm(2) vs. 2.96 ± 1.91 mm(2), p = 0.250), the area of ruptured cavity was significantly larger in STEMI compared with NSTEACS (2.52 ± 1.36 mm(2) vs. 1.67 ± 1.37 mm(2), p = 0.034). Furthermore, the ruptured plaque of which aperture was open-wide against the direction of coronary flow was more often seen in STEMI compared with NSTEACS (46% vs. 17%, p = 0.036). CONCLUSIONS: The present OCT study demonstrated the differences of the culprit lesion morphologies between STEMI and NSTEACS. The morphological feature of plaque rupture and the intracoronary thrombus could relate to the clinical presentation in patients with acute coronary disease.
OBJECTIVES: The aim of this study was to investigate the difference of culprit lesion morphologies assessed by optical coherence tomography (OCT) between ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndrome (NSTEACS). BACKGROUND: Autopsy studies have reported that rupture of a thin-cap fibroatheroma and subsequent thrombus formation is the most important mechanism leading to acute coronary syndrome (ACS). Optical coherence tomography is a high-resolution imaging modality that is capable of investigating detailed coronary plaque morphology in vivo. METHODS: We examined the culprit lesion morphologies by OCT in 89 consecutive patients with acute coronary syndrome (STEMI = 40; NSTEACS = 49). RESULTS: The incidence of plaque rupture, thin-cap fibroatheroma, and red thrombus was significantly higher in STEMI compared with NSTEACS (70% vs. 47%, p = 0.033, 78% vs. 49%, p = 0.008, and 78% vs. 27%, p < 0.001, respectively). Although the lumen area at the site of plaque rupture was similar in the both groups (2.44 ± 1.34 mm(2) vs. 2.96 ± 1.91 mm(2), p = 0.250), the area of ruptured cavity was significantly larger in STEMI compared with NSTEACS (2.52 ± 1.36 mm(2) vs. 1.67 ± 1.37 mm(2), p = 0.034). Furthermore, the ruptured plaque of which aperture was open-wide against the direction of coronary flow was more often seen in STEMI compared with NSTEACS (46% vs. 17%, p = 0.036). CONCLUSIONS: The present OCT study demonstrated the differences of the culprit lesion morphologies between STEMI and NSTEACS. The morphological feature of plaque rupture and the intracoronary thrombus could relate to the clinical presentation in patients with acute coronary disease.
Authors: Hesham Refaat; Giampaolo Niccoli; Mario Gramegna; Rocco A Montone; Francesco Burzotta; Antonio M Leone; Carlo Trani; Ahmed S Ammar; Islam A Elsherbiny; Giancarla Scalone; Francesco Prati; Filippo Crea Journal: Int J Cardiovasc Imaging Date: 2015-02-28 Impact factor: 2.357
Authors: Ravinay Bhindi; Olli A Kajander; Sanjit S Jolly; Saleem Kassam; Shahar Lavi; Kari Niemelä; Anthony Fung; Asim N Cheema; Brandi Meeks; Dimitrios Alexopoulos; Viktor Kočka; Warren J Cantor; Timo P Kaivosoja; Olga Shestakovska; Peggy Gao; Goran Stankovic; Vladimír Džavík; Tej Sheth Journal: Eur Heart J Date: 2015-05-20 Impact factor: 29.983
Authors: Charis Costopoulos; Adam J Brown; Zhongzhao Teng; Stephen P Hoole; Nick E J West; Habib Samady; Martin R Bennett Journal: Int J Cardiovasc Imaging Date: 2015-07-08 Impact factor: 2.357
Authors: Micheli Zanotti Galon; Zhao Wang; Hiram G Bezerra; Pedro Alves Lemos; Audrey Schnell; David L Wilson; Andrew M Rollins; Marco A Costa; Guilherme F Attizzani Journal: Catheter Cardiovasc Interv Date: 2014-10-04 Impact factor: 2.692