Mario Iannaccone1, Giorgio Quadri2, Salma Taha2, Fabrizio D'Ascenzo2, Antonio Montefusco2, Pierluigi Omede'2, Ik-Kyung Jang3, Giampaolo Niccoli4, Geraud Souteyrand5, Chen Yundai6, Konstantinos Toutouzas7, Sara Benedetto2, Umberto Barbero2, Umberto Annone2, Enrica Lonni2, Yoichi Imori8, Giuseppe Biondi-Zoccai9, Christian Templin10, Claudio Moretti2, Thomas F Luscher10, Fiorenzo Gaita2. 1. Divisione di Cardiologia, Dipartimento di Scienze Mediche, Città della Salute e della Scienza, Turin, Italy mario.iannaccone@hotmail.it. 2. Divisione di Cardiologia, Dipartimento di Scienze Mediche, Città della Salute e della Scienza, Turin, Italy. 3. Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. 4. Division of Cardiology, Cattolica del Sacro Cuore, Roma, Italy. 5. Pole Cardiologie, Centre Hospitalier Universitaire de Clermont-Ferrant, Clermont-Ferrant, France. 6. Department of Cardiology, Chinese PLA General Hospital, Beijing, China. 7. Athens Medical School, Hippokration Hospital, Athens, Greece. 8. Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan University Hospital, Zurich, Switzerland. 9. Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy. 10. University Hospital, Zurich, Switzerland.
Abstract
AIMS: The prevalence of plaque rupture at the culprit lesion identified by optical coherence tomography (OCT) in different clinical subset of patients undergoing coronary angiography and its clinical predictors remain to be defined. METHODS: All studies including patients with OCT evaluation of the culprit coronary plaque were included. The prevalence of culprit plaque rupture (CPR) and thin-cap fibro-atheroma (TCFA) were the primary endpoints. The factors associated with these findings were studied in a subset of patients with different clinical presentations [ST-elevation myocardial (STEMI) vs. nonST-elevation myocardial infarction (NSTEMI) vs. unstable angina (UA) vs. stable angina pectoris (SAP)]. RESULTS: One hundred and fifty citations were initially appraised at the abstract level and 23 full-text studies were assessed. The mean prevalence of CPR and TCFA was 48.1% (40.5-55.8) and 48.7% (37.4-60.1), respectively. The prevalence of CPR and TCFA were higher in STEMI (70.4 and 76.6%) than in NSTEMI (55.6 and 56.3%) and UA (39.1 and 52.9%) or SAP (6.2 and 22.8%). In the overall population at meta-regression analysis, TCFA and current smoking were the only predictors of CPR (B 3.6:2.0-5.1, P < 0.001 and 0.06:0.02-0.1, P = 0.002, respectively). The factors associated with CPR were different depending on clinical presentation. Hypertension was the only clinical predictor for STEMI (B 3.3: 1.2.-5.3 P = 0.001), while advanced age (B 0.12: 0.02-0.22, P = 0.021), diabetes mellitus (B 0.04: 0.01-0.08, P = 0.012), and hyperlipidaemia (B 0.07:0.02-0.11, P = 0.005) were the predictors in NSTEMI and UA. No clinical predictor was found in SA. CONCLUSIONS: Our analysis showed high rates of CPR and TCFA detected by OCT in CAD patients, especially in those with ACS, although their prevalence is not negligible in stable patients. TCFA seems to be a strong predictor of CPR in all the ACS scenarios. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: The prevalence of plaque rupture at the culprit lesion identified by optical coherence tomography (OCT) in different clinical subset of patients undergoing coronary angiography and its clinical predictors remain to be defined. METHODS: All studies including patients with OCT evaluation of the culprit coronary plaque were included. The prevalence of culprit plaque rupture (CPR) and thin-cap fibro-atheroma (TCFA) were the primary endpoints. The factors associated with these findings were studied in a subset of patients with different clinical presentations [ST-elevation myocardial (STEMI) vs. nonST-elevation myocardial infarction (NSTEMI) vs. unstable angina (UA) vs. stable angina pectoris (SAP)]. RESULTS: One hundred and fifty citations were initially appraised at the abstract level and 23 full-text studies were assessed. The mean prevalence of CPR and TCFA was 48.1% (40.5-55.8) and 48.7% (37.4-60.1), respectively. The prevalence of CPR and TCFA were higher in STEMI (70.4 and 76.6%) than in NSTEMI (55.6 and 56.3%) and UA (39.1 and 52.9%) or SAP (6.2 and 22.8%). In the overall population at meta-regression analysis, TCFA and current smoking were the only predictors of CPR (B 3.6:2.0-5.1, P < 0.001 and 0.06:0.02-0.1, P = 0.002, respectively). The factors associated with CPR were different depending on clinical presentation. Hypertension was the only clinical predictor for STEMI (B 3.3: 1.2.-5.3 P = 0.001), while advanced age (B 0.12: 0.02-0.22, P = 0.021), diabetes mellitus (B 0.04: 0.01-0.08, P = 0.012), and hyperlipidaemia (B 0.07:0.02-0.11, P = 0.005) were the predictors in NSTEMI and UA. No clinical predictor was found in SA. CONCLUSIONS: Our analysis showed high rates of CPR and TCFA detected by OCT in CAD patients, especially in those with ACS, although their prevalence is not negligible in stable patients. TCFA seems to be a strong predictor of CPR in all the ACS scenarios. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Beatrice von Jeinsen; Stergios Tzikas; Gerhard Pioro; Lars Palapies; Tanja Zeller; Christoph Bickel; Karl J Lackner; Stephan Baldus; Stefan Blankenberg; Thomas Muenzel; Andreas M Zeiher; Till Keller Journal: PLoS One Date: 2016-05-05 Impact factor: 3.240
Authors: Jan-Quinten Mol; Anouar Belkacemi; Rick Hja Volleberg; Martijn Meuwissen; Alexey V Protopopov; Peep Laanmets; Oleg V Krestyaninov; Robert Dennert; Rohit M Oemrawsingh; Jan-Peter van Kuijk; Karin Arkenbout; Dirk J van der Heijden; Saman Rasoul; Erik Lipsic; Steven Teerenstra; Cyril Camaro; Peter Damman; Maarten Ah van Leeuwen; Robert-Jan van Geuns; Niels van Royen Journal: BMJ Open Date: 2021-07-07 Impact factor: 2.692