Optical Coherence Tomographic Features of Pancoronary Plaques in Patients With Acute Myocardial Infarction Caused by Layered Plaque Rupture Versus Layered Plaque Erosion

2022 ◽  
Author(s):  
Yanwei Yin ◽  
Chao Fang ◽  
Senqing Jiang ◽  
Jifei Wang ◽  
Yidan Wang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Plaque Rupture ◽  
Optical Coherence ◽  
Plaque Erosion

Metabolic syndrome predicts plaque rupture in patients with acute myocardial infarction. An optical coherence study

2016 ◽  
Vol 209 ◽  
pp. 139-141 ◽  
Author(s):  
Andreas Synetos ◽  
Angelos Papanikolaou ◽  
Konstantinos Toutouzas ◽  
George Georgiopoulos ◽  
Antonis Karanasos ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Metabolic Syndrome ◽  
Acute Myocardial Infarction ◽  
Plaque Rupture ◽  
Optical Coherence

CARDIOVASCULAR DISEASES: PREVALENCE, RISK FACTORS (LITERATURE REVIEW)

Vestnik ◽  
2021 ◽  
pp. 84-92
Author(s):  
М.О. Мустафина ◽  
А. Телжанов ◽  
З.Н. Лигай
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Plaque Rupture ◽  
Young Patients ◽  
Microvascular Dysfunction ◽  
Artery Dissection ◽  
Variant Angina ◽  
Coronary Artery Dissection ◽  
Plaque Erosion

Мы провели поиск в PubMed статей, опубликованных с 1980 по 2020, используя термины «острый инфаркт миокарда», «молодой», «разрыв бляшки», эрозия бляшки, спонтанное расслоение коронарной артерии (SCAD), коронарный вазоспазм», «вариантная стенокардия или стенокардия Принцметала», «лекарственный инфаркт миокарда», «миокардит», «коронарная эмболия», «микрососудистая дисфункция», «MINOCA», а также обзор всех опубликованных исследований. Используя данные этого поиска, мы стремимся проинформировать читателей о распространенности, факторах риска, проявлениях и лечении острого инфаркта миокарда у молодых пациентов, а также подробно рассказать о специальных подгруппах с диагностическими и терапевтическими проблемами. We searched PubMed for articles published from 1980 to 2020 using the terms acute myocardial infarction, young, plaque rupture, plaque erosion, spontaneous coronary artery dissection (SCAD), coronary vasospasm, variant angina or angina pectoris. Prinzmetal, drug myocardial infarction, myocarditis, coronary embolism, microvascular dysfunction, MINOCA, and a review of all published studies. Using the data from this search, we aim to inform readers about the prevalence, risk factors, manifestations and treatment of acute myocardial infarction in young patients, as well as detail the special subgroups with diagnostic and therapeutic problems.

scholarly journals Prevalence, Features, and Prognosis of Artery‐to‐Artery Embolic ST‐Segment–Elevation Myocardial Infarction: An Optical Coherence Tomography Study

2020 ◽  
Vol 9 (24) ◽  
Author(s):  
Masahiro Takahata ◽  
Yasushi Ino ◽  
Takashi Kubo ◽  
Takashi Tanimoto ◽  
Akira Taruya ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Optical Coherence Tomography ◽  
Plaque Rupture ◽  
Optical Coherence ◽  
Lumen Area ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Plaque Erosion ◽  
St Segment ◽  
Rupture Site

Background The major underlying mechanisms contributing to acute coronary syndrome are plaque rupture, plaque erosion, and calcified nodule. Artery‐to‐artery embolic myocardial infarction (AAEMI) was defined as ST‐segment–elevation myocardial infarction caused by migrating thrombus formed at the proximal ruptured plaque. The aim of this study was to investigate the prevalence and clinical features of AAEMI by using optical coherence tomography. Methods and Results This study retrospectively enrolled 297 patients with ST‐segment–elevation myocardial infarction who underwent optical coherence tomography before percutaneous coronary intervention. Patients were divided into 4 groups consisting of plaque rupture, plaque erosion, calcified nodule, and AAEMI according to optical coherence tomography findings. The prevalence of AAEMI was 3.4%. The culprit vessel in 60% of patients with AAEMI was right coronary artery. Minimum lumen area at the culprit site was larger in AAEMI compared with plaque rupture, plaque erosion, and calcified nodule (4.0 mm 2 [interquartile range (IQR), 2.2–4.9] versus 1.0 mm 2 [IQR, 0.8–1.3] versus 1.0 mm 2 [IQR, 0.8–1.2] versus 1.1 mm 2 [IQR, 0.7–1.6], P <0.001). Lumen area at the rupture site was larger in patients with AAEMI compared with patients with plaque rupture (4.4 mm 2 [IQR, 2.5–6.7] versus 1.5 mm 2 [IQR, 1.0–2.4], P <0.001). In patients with AAEMI, the median minimum lumen area at the occlusion site was 1.2 mm 2 (IQR, 1.0–2.1), 40% of them had nonstent strategy, and the 3‐year major adverse cardiac event rate was 0%. Conclusions AAEMI is a rare cause for ST‐segment–elevation myocardial infarction and has unique morphological features of plaque including larger lumen area at rupture site and smaller lumen area at the occlusion site.

Abstract 16100: Incidence and Morphologic Characteristics of Plaque Erosion in Patients With Acute Myocardial Infarction: A Combined Optical Coherence Tomography and Intravascular Ultrasound Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Takumi Higuma ◽  
Soeda Tsunenari ◽  
Naoki Abe ◽  
Masahiro Yamada ◽  
Hiroaki Yokoyama ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Optical Coherence Tomography ◽  
Intravascular Ultrasound ◽  
Plaque Burden ◽  
Optical Coherence ◽  
True Incidence ◽  
Eccentricity Index ◽  
Plaque Erosion ◽  
Ultrasound Study

Background: The underlying mechanisms for acute myocardial infarction (AMI) include plaque rupture (PR), plaque erosion (PE), and calcific nodule (CN). Recently, in vivo diagnosis of PE was reported in patients with acute coronary syndromes (ACS) using optical coherence tomography (OCT). However, the true incidence of erosion in patients with AMI remains unknown. Aim: The aims of this study were (1) to evaluate the incidence of PR, PE, and CN in patients with AMI during the acute phase and (2) to compare the detailed plaque morphology in all 3 groups using both OCT and intravascular ultrasound (IVUS). Methods and Results: In 77 patients with AMI, both OCT and IVUS were performed following manual aspiration thrombectomy. Culprit plaques were classified into PR, PE, and CN using the established OCT criteria. The frequency of PR, PE, and CN were 62.3%, 27.2%, and 6.5%, respectively. PE had significantly lower prevalence of thin-cap fibroatheroma (TCFA), thicker fibrous cap and smaller lipid arc. Compared to PR and PE, CN had greater calcification (Table). On IVUS, plaque eccentricity index was significantly greater in PE compared to the others. PR and PE showed greater plaque burden. The remodeling index was different among these 3 groups. 75.0% of PR had positive remodeling but none in CN. In contrast, CN had higher prevalence of negative remodeling. The prevalence of superficial spotty calcification was higher in PR than the other 2 groups. Conclusion: This combined OCT and IVUS study demonstrates that erosion was the underlying mechanism in 27.2% of patients with AMI. In eroded plaques, TCFA was rare and eccentricity index was significantly greater.

Abstract 17859: Gender Difference in Underlying Plaque Morphology of the Culprit Lesion in Patients with Acute Myocardial Infarction: an in vivo Optical Coherence Tomography Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Sining Hu ◽  
Haibo Jia ◽  
Tsunenari Soeda ◽  
Yoshiyasu Minami ◽  
Rocco Vergallo ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Optical Coherence Tomography ◽  
Gender Difference ◽  
Plaque Rupture ◽  
Morphological Characteristics ◽  
Plaque Morphology ◽  
Optical Coherence ◽  
Culprit Lesion

Introduction: Autopsy studies in sudden cardiac death subjects showed female had higher incidence of erosion. However, the incidence of erosion in patients with acute myocardial infarction (AMI) has not been systematically studied. Hypothesis: This study was to study the gender difference in the prevalence and morphological characteristics of the culprit lesion in patients with AMI using intravascular optical coherence tomography (OCT). Methods: A total of 79 patients (65 male and 14 female) with AMI who underwent pre-intervention OCT imaging of the culprit lesion were included. Results: Baseline characteristics between the two groups were similar. In OCT findings, the incidence of thin-cap fibroatheroma (TCFA) was slightly lower and the fibrous cap thickness was slightly thicker in female than in male, but the differences were not significant. Defining underlying plaque morphology by genders, plaque erosion was more prevalent in female than in male, whereas plaque rupture was more frequent in male (Table). Conclusions: Erosion was the most frequent cause of AMI in female patients, whereas plaque rupture is the predominant underlying pathology of AMI in male patients.

scholarly journals P4402Metabolic syndrome predicts plaque rupture in patients with acute myocardial Infarction. An optical coherence study

2017 ◽  
Vol 38 (suppl_1) ◽  
Author(s):  
A. Synetos ◽  
A. Papanikolaou ◽  
G. Georgiopoulos ◽  
G. Peskesis ◽  
M. Drakopoulou ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Plaque Rupture ◽  
Optical Coherence

Coronary plaque rupture is associated with carotid thermal heterogeneity in patients presenting with acute myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P Bounas ◽  
A Synetos ◽  
A Karanasos ◽  
A Papanikolaou ◽  
M Drakopoulou ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Plaque Rupture ◽  
Imaging Method ◽  
Prognostic Impact ◽  
Optical Coherence ◽  
Culprit Lesion ◽  
Fibrous Cap ◽  
Thermal Heterogeneity ◽  
The Impact

Abstract Introduction Vulnerable plaques of the coronary arteries, share common characteristics such as the thin cap fibrous cap, that make the prone to rupture in the presence of stimulus such as shear stress or inflammation. Optical coherence tomography (OCT) is an imaging method, by which the fibrous cap and the presence of plaque rupture can be accurately in vivo visualized. Recent studies have shown an association between increased carotid temperature heterogeneity (ΔT) detected by microwave radiometry (MWR) and cardiovascular events. Purpose To evaluate the impact of carotid temperature heterogeneity on the culprit plaque morphology on patients presenting with acute myocardial infarction. Method A total of 37 patients undergoing percutaneous coronary intervention (PCI) for an acute myocardial infarction who had an identifiable de novo culprit lesion in a native coronary artery, were enrolled in this study. All patients underwent PCI and Optical Coherence Study (OCT) within 12 hours since symptom onset. The culprit lesion of the angiogram was clearly identified by a combination of ECG, wall motion abnormalities seen in cardiac ultrasound, and coronary angiogram. The OCT study was performed using the LightLab OCT wire, and acquired images were analyzed by 2 independent investigators using previously validated criteria for OCT plaque characterization. After the completion of the PCI all patients underwent MWR of both carotid arteries and ΔT was defined as maximal temperature detected along each carotid artery minus minimum. Results Thirty four patients with acute myocardial infarction 21 with STEMI (61.76%) and 13 (38.23%) with NSTEMI were included in the study. STEMI patients had more ruptured plaques compared to NSTEMI patients (71.41 versus 38.46%, p=0.053). Thin cap fibroatheroma (TCFA) was present in 31 patients (91.1%), while all ruptured plaques had a TCFA compared to 11 TCFA (78.57%) observed in plaques that had no rupture (p=0.03). HsCRP was significantly increased in ruptured plaques compared to non ruptured ones (14.41±4.02 versus 9.9±2,5, p&lt;0.005). Mean ΔT was significantly increased in ruptured plaques compared to no ruptured ones (1.01±0.31 versus 0.51±0.14°C, p&lt;0.005), as well as in plaques with TCFA compared to those without a TCFA (0.82±0.37 versus 0.60±0.05°C, p=0.001). In the multivariate analysis, STEMI, hsCRP, and ΔT were entered from which hsCRP (OR 1.51; 95% CI 0.99–2.28; P=0.051) and ΔT ((OR for 0.1°C increase 3.40; 95% CI 1.29–8.96; P=0.013) remained in the final model, with ΔT being the only variable independently associated with the presence of rupture. Conclusions Carotid thermal heterogeneity is associated with the presence of plaque rupture in patients with acute myocardial infarction. Further studies are needed in order to assess the possible prognostic impact of carotid ΔT on such population. Funding Acknowledgement Type of funding source: None

106Plasma trimethylamine N-oxide is associated with culprit plaque characterization as assessed by optical coherence tomography in patients with acute myocardial infarction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Z Sheng ◽  
Y Tan ◽  
H Yan
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Optical Coherence Tomography ◽  
Plaque Rupture ◽  
Demographic Data ◽  
Coronary Plaque ◽  
Optical Coherence ◽  
Plaque Characterization ◽  
Medical Sciences ◽  
Laboratory Findings

Abstract Background Previous study have demonstrated that plasma trimethylamine N-oxide (TMAO) is associated with vulnerable plaque characteristics as assessed by optical coherence tomography (OCT) in patients with coronary artery disease. However, the relation between TMAO and the culprit plaque characteristics as assessed by OCT in patients with acute myocardial infarction (AMI) exhibiting plaque rupture at the site of the culprit stenosis is unknown. Objective To explore the relation between plasma TMAO and coronary culprit plaque characterization assessed by OCT in AMI patients exhibiting plaque rupture. Method We prospectively enrolled 90 AMI patients with plaque rupture identified by OCT and collected demographic data, risk factors, coronary angiography and OCT data, medical history and laboratory findings of all patients. Plasma TMAO levels were detected by stable isotope dilution liquid chromatography tandem mass spectrometry. Macrophage presence in coronary culprit plaque was quantified by normalized standard deviation (NSD). Result All patients were divided into two groups (high TMAO group and low TMAO group) according to the median plasma TMAO level (3.22uM). The culprit plaques in the high TMAO group exhibited a thinner fibrous cap thickness (60um [60–100um] versus 90um [70–110um], P=0.013]), higher frequency of thin-cap fibroatheroma (TCFA) (15.6% versus 55.6%, P<0.001), microvessel (24.4% versus 4.4%, P=0.014) and macrophage infiltration (66.7% versus 26.7%, P<0.001) compared with the low TMAO group. Moreover, the level of TMAO was significantly positively associated with NSD (Pearson's correlation coefficient: r=0.766, P<0.001). Conclusion Plasma TMAO levels are associated with coronary plaque vulnerability and inflammation in patients with AMI exhibiting plaque rupture. Acknowledgement/Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (2016-I2M-1-009)

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