Comparison of Coronary Culprit Lesion Morphology Determined by Optical Coherence Tomography and Relation to Outcomes in Patients Diagnosed with Acute Coronary Syndrome During Winter –vs– Other Seasons

2019 ◽  
Vol 124 (1) ◽  
pp. 31-38
Author(s):  
Junsuke Shibuya ◽  
Nobuaki Kobayashi ◽  
Kuniya Asai ◽  
Masafumi Tsurumi ◽  
Yusaku Shibata ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Acute Coronary Syndrome ◽  
Optical Coherence ◽  
Culprit Lesion ◽  
Coronary Syndrome ◽  
Lesion Morphology

Impact of Accumulated Serum Uric Acid on Coronary Culprit Lesion Morphology Determined by Optical Coherence Tomography and Cardiac Outcomes in Patients with Acute Coronary Syndrome

Cardiology ◽  
2018 ◽  
Vol 141 (4) ◽  
pp. 190-198 ◽  
Author(s):  
Nobuaki Kobayashi ◽  
Kuniya Asai ◽  
Masafumi Tsurumi ◽  
Yusaku Shibata ◽  
Hirotake Okazaki ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Acute Coronary Syndrome ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Plaque Morphology ◽  
Optical Coherence ◽  
Cardiac Mortality ◽  
Culprit Lesion ◽  
Coronary Syndrome ◽  
Very High

Objectives: We aimed to examine the relations of very high levels of serum uric acid (sUA) with features of culprit lesion plaque morphology determined by optical coherence tomography (OCT) and adverse clinical outcomes in patients with acute coronary syndrome (ACS). Methods: We retrospectively compared ACS patients according to sUA levels of > 8.0 mg/dL (n = 169), 7.1–8.0 mg/dL (n = 163), 6.1–7.0 mg/dL (n = 259), and ≤6.0 mg/dL (n = 717). Angiography and OCT findings were analyzed in patients with preintervention OCT and the 4 sUA groups (> 8.0 mg/dL, n = 61; 7.1–8.0 mg/dL, n = 72; 6.1–7.0 mg/dL, n = 131; and ≤6.0 mg/dL, n = 348) were compared. Results: Cardiogenic shock was more prevalent in ACS patients with sUA > 8.0 mg/dL (22% vs. 19% vs. 10% vs. 6%, p < 0.001). Plaque rupture was observed more prevalently by OCT in patients with sUA > 8.0 mg/dL (67% vs. 47% vs. 56% vs. 45%, p = 0.027). At the 2-year follow-up, Kaplan-Meier estimates showed higher cardiac mortality in patients with sUA > 8.0 mg/dL (25% vs. 12% vs. 5% vs. 5%, p < 0.001). After adjusting for traditional cardiovascular risk factors and creatinine levels, patients with sUA > 8.0 mg/dL showed a 4.5-fold increased risk in 2-year cardiac death by multivariate Cox proportional hazard analysis (hazard ratio 4.54, 95% confidence interval 2.98–6.91; p < 0.001). Conclusions: Very high sUA levels like > 8.0 mg/dL are the primary predictor of 2-year cardiac mortality and could partly be caused by adverse effects of accumulated sUA on plaque morphology in patients with ACS.

Features and Outcomes of Patients with Calcified Nodules at Culprit Lesions of Acute Coronary Syndrome: An Optical Coherence Tomography Study

Cardiology ◽  
2018 ◽  
Vol 139 (2) ◽  
pp. 90-100 ◽  
Author(s):  
Nobuaki Kobayashi ◽  
Masamichi Takano ◽  
Masafumi Tsurumi ◽  
Yusaku Shibata ◽  
Suguru Nishigoori ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Acute Coronary Syndrome ◽  
Plaque Rupture ◽  
Target Lesion ◽  
Cross Sectional Area ◽  
Optical Coherence ◽  
Sectional Area ◽  
Culprit Lesion ◽  
Cross Sectional ◽  
Coronary Syndrome

Objectives: We sought to clarify clinical features and outcomes related to calcified nodules (CN) compared with plaque rupture (PR) and plaque erosion (PE) detected by optical coherence tomography (OCT) at the culprit lesions in patients with acute coronary syndrome (ACS). Methods: Based on OCT findings for culprit lesion plaque morphologies, ACS patients with analyzable OCT images (n = 362) were classified as CN, PR, PE, and other. Results: The prevalence of CN, PR, and PE was 6% (n = 21), 45% (n = 163), and 41% (n = 149), respectively. Patients with CN were older (median 71 vs. 65 years, p = 0.03) and more diabetic (71 vs. 35%, p = 0.002) than those without CN. In OCT findings, the distal reference lumen cross-sectional area (median 4.2 vs. 5.2 mm2, p = 0.048) and the postintervention minimum lumen cross-sectional area (median 4.5 vs. 5.3 mm2, p = 0.04) were smaller in lesions with CN than in those without. Kaplan-Meier estimate survival curves showed that the 500-day survival without target lesion revascularization (TLR) was lower (p = 0.011) for patients with CN (72.9%) than for those with PR (89.3%) or PE (94.8%). Conclusions: ACS patients with CN at the culprit lesion had more TLR compared to those with PR or PE.

scholarly journals Culprit lesion characteristics in very young patients with acute coronary syndrome: An optical coherence tomography study

2021 ◽  
Vol 25 (10) ◽  
pp. 684-690
Author(s):  
Sharad Chandra ◽  
◽  
Snigdha Boddu ◽  
Gaurav Chaudhary ◽  
Akhil Sharma ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Acute Coronary Syndrome ◽  
Young Patients ◽  
Optical Coherence ◽  
Culprit Lesion ◽  
Coronary Syndrome

Abstract 12944: Patients With Acute Coronary Syndrome, Compared to Those With Stable Angina Pectoris, Have Increased Bright Spots at the Culprit Site by Optical Coherence Tomography

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Yoshiyasu Minami ◽  
Jennifer E Phipps ◽  
Taylor Hoyt ◽  
Marc D Feldman ◽  
Ik-Kyung Jang
Keyword(s):  
Optical Coherence Tomography ◽  
Acute Coronary Syndrome ◽  
Angina Pectoris ◽  
Stable Angina ◽  
Coronary Risk Factors ◽  
Optical Coherence ◽  
Culprit Lesion ◽  
Stable Angina Pectoris ◽  
Coronary Syndrome ◽  
Bright Spots

Background: Recent studies reported that bright spots detected by optical coherence tomography (OCT) represent more complex plaques including macrophages and cholesterol crystals. We hypothesized that the density and area of bright spots would be greater at the culprit lesion in patients with acute coronary syndrome (ACS) compared to those with stable angina pectoris (SAP). Aim: To compare the density and extent of bright spots in the culprit lesion between patients with ACS and with SAP. Methods: We identified 14 ACS and 17 SAP patients who underwent pre-PCI OCT imaging of the culprit lesion. Cases with poor image quality or left main disease were excluded. Bright spots within superficial 125μm of the vessel wall were identified in a 5mm length segment at the culprit site. The density was calculated as the number of bright pixels identified by the algorithm divided by the number of pixels in each frame (total 25 frames in one case). The area of bright spots was also calculated. Results: There were no significant differences in the baseline characteristics including mean age (65.9 ± 10.2 vs 65.2 ± 9.32 yrs, P=0.83) and the prevalence of coronary risk factors between ACS and SAP. Mean and maximum density of bright spots was significantly greater in ACS than in SAP (Table). The area of bright spots was also significantly larger in ACS. Among ACS patients, a subgroup with plaque rupture (n=11) had much greater mean density and area compared with SAP (1.20 [0.41-1.73] vs 0.44 [0.21-0.58], P=0.01, 5.32 [1.88-8.07] vs 2.06 [0.97-2.64], P=0.01). Conclusions: Using the novel algorithm, we demonstrate that the density and area of bright spots are significantly greater in ACS than in SAP. This result suggests that the measurement of bright spots can be useful to determine plaque vulnerability.

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