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Qualitative and quantitative evaluation of dynamic changes in non-culprit coronary atherosclerotic Léesion Morphology A longitudinal OCT study


Zhang, Bu-Chun; Karanasos, Antonios; Gnanadesigan, Muthukaruppan; van der Sijde, Johannes N; van Ditzhuijzen, Nienke S; Witberg, Karen T; Ligthart, Jurgen; Diletti, Roberto; van Geuns, Robert-Jan; Dijkstra, Jouke; Zijlstra, Felix; van Soest, Gijs; Regar, Evelyn (2018). Qualitative and quantitative evaluation of dynamic changes in non-culprit coronary atherosclerotic Léesion Morphology A longitudinal OCT study. EuroIntervention, 13(18):2190-2200.

Abstract

AIMS: There is limited in vivo evidence regarding the temporal evolution of non-culprit coronary plaque morphology. We evaluated changes in non-culprit plaque morphology over time by optical coherence tomography (OCT).
METHODS AND RESULTS: 72 patients with 257 non-culprit segments with serial OCT studies were analyzed. Non-culprit 5mm-long coronary segments from the same imaged region were matched between baseline and follow-up. OCT plaque characterization including automated attenuation analysis was performed and changes over a median follow-up of 6.2 months were evaluated. On segment level, lumen area decreased from baseline to follow-up, whereas fibrous cap thickness increased. Similarly, plaque attenuation indexes at follow-up were significantly decreased. Minimal cap thickness per patient did not change. In 68.5% of segments plaque morphology did not change. Favorable change was observed in 18.4% of segments and unfavorable in 12.9%. There were no robust clinical predictors of change in plaque morphology. Attenuation analysis supported the qualitative characterization, showing significantly different attenuation between different plaque types.
CONCLUSIONS: In non-culprit coronary segments of patients with coronary artery disease under standard medical therapy, segment-level but not patient-level minimum fibrous cap thickness increases over time, with observations of both favorable and unfavorable changes in individual segments.

Abstract

AIMS: There is limited in vivo evidence regarding the temporal evolution of non-culprit coronary plaque morphology. We evaluated changes in non-culprit plaque morphology over time by optical coherence tomography (OCT).
METHODS AND RESULTS: 72 patients with 257 non-culprit segments with serial OCT studies were analyzed. Non-culprit 5mm-long coronary segments from the same imaged region were matched between baseline and follow-up. OCT plaque characterization including automated attenuation analysis was performed and changes over a median follow-up of 6.2 months were evaluated. On segment level, lumen area decreased from baseline to follow-up, whereas fibrous cap thickness increased. Similarly, plaque attenuation indexes at follow-up were significantly decreased. Minimal cap thickness per patient did not change. In 68.5% of segments plaque morphology did not change. Favorable change was observed in 18.4% of segments and unfavorable in 12.9%. There were no robust clinical predictors of change in plaque morphology. Attenuation analysis supported the qualitative characterization, showing significantly different attenuation between different plaque types.
CONCLUSIONS: In non-culprit coronary segments of patients with coronary artery disease under standard medical therapy, segment-level but not patient-level minimum fibrous cap thickness increases over time, with observations of both favorable and unfavorable changes in individual segments.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiovascular Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2018
Deposited On:19 Dec 2017 15:41
Last Modified:07 Apr 2018 01:01
Publisher:Europa Digital and Publishing
ISSN:1774-024X
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.4244/EIJ-D-17-00161
PubMed ID:29131800

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