Effects of statins on plaque rupture assessed by optical coherence tomography in patients presenting with acute coronary syndromes: insights from the optical coherence tomography (OCT)-FORMIDABLE registry

Background. Recent intravascular ultrasound (IVUS) studies have demonstrated that hypoechoic plaque with deep ultrasound attenuation despite absence of bright calcium is common in acute coronary syndrome. Such “attenuated plaque” may be an IVUS characteristic of unstable lesion.Methods. We used optical coherence tomography (OCT) in 104 patients with unstable angina to compare lesion characteristics between IVUS-detected attenuated plaque and nonattenuated plaque.Results. IVUS-detected attenuated plaque was observed in 41 (39%) patients. OCT-detected lipidic plaque (88% versus 49%, ), thin-cap fibroatheroma (48% versus 16%, ), plaque rupture (44% versus 11%, ), and intracoronary thrombus (54% versus 17%, ) were more often seen in IVUS-detected attenuated plaques compared with nonattenuated plaques.Conclusions. IVUS-detected attenuated plaque has many characteristics of unstable coronary lesion. The presence of attended plaque might be an important marker of lesion instability.

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Coronary CT angiographic characteristics of culprit lesions in acute coronary syndromes not related to plaque rupture as defined by optical coherence tomography and angioscopy

European Heart Journal ◽

10.1093/eurheartj/ehr189 ◽

2011 ◽

Vol 32 (22) ◽

pp. 2814-2823 ◽

Cited By ~ 94

Author(s):

Y. Ozaki ◽

M. Okumura ◽

T. F. Ismail ◽

S. Motoyama ◽

H. Naruse ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Acute Coronary Syndromes ◽

Plaque Rupture ◽

Optical Coherence ◽

Coronary Ct ◽

Coronary Syndromes

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Optical Coherence Tomography Imaging in Acute Coronary Syndromes

Cardiology Research and Practice ◽

10.4061/2011/312978 ◽

2011 ◽

Vol 2011 ◽

pp. 1-7 ◽

Cited By ~ 7

Author(s):

Takashi Kubo ◽

Yasushi Ino ◽

Takashi Tanimoto ◽

Hironori Kitabata ◽

Atsushi Tanaka ◽

...

Keyword(s):

Optical Coherence Tomography ◽

High Resolution ◽

Acute Coronary Syndromes ◽

Plaque Rupture ◽

Vasa Vasorum ◽

Optical Coherence ◽

Coronary Syndrome ◽

Vulnerable Plaques ◽

Coronary Syndromes

Optical coherence tomography (OCT) is a high-resolution imaging technique that offers microscopic visualization of coronary plaques. The clear and detailed images of OCT generate an intense interest in adopting this technique for both clinical and research purposes. Recent studies have shown that OCT is useful for the assessment of coronary atherosclerotic plaques, in particular the assessment of plaque rupture, erosion, and intracoronary thrombus in patients with acute coronary syndrome. In addition, OCT may enable identifying thin-cap fibroatheroma, the proliferation of vasa vasorum, and the distribution of macrophages surrounding vulnerable plaques. With its ability to view atherosclerotic lesions in vivo with such high resolution, OCT provides cardiologists with the tool they need to better understand the thrombosis-prone vulnerable plaques and acute coronary syndromes. This paper reviews the possibility of OCT for identification of vulnerable plaques in vivo.

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