Abstract 17709: Framingham Risk Score and Coronary Plaque Characteristics as Assessed by Three-Vessel Optical Coherence Tomography Imaging

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Rocco Vergallo ◽  
Haibo Jia ◽  
Tsunenari Soeda ◽  
Yoshiyasu Minami ◽  
Sining Hu ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Prediction Models ◽  
Coronary Plaque ◽  
Optical Coherence ◽  
Cholesterol Crystals ◽  
Coronary Syndrome ◽  
Framingham Risk ◽  
Risk Increase

Introduction: Clinical prediction models, such as the Framingham Risk Score (FRS), are useful to identify patients at high risk for future events. However, their association with coronary plaque features is largely unknown. Aim: This study aimed at evaluating the relationship between FRS and coronary plaque features by optical coherence tomography (OCT). Methods: FRS was assessed in 176 patients with coronary artery disease [72 with acute coronary syndrome (ACS), and 104 with stable angina] who underwent 3-vessel OCT imaging. Based on the FRS values, patients were divided into 3 groups: lower FRS (FRS<5%, n=26), intermediate FRS (5%≤FRS<10%, n=105), and higher FRS (FRS≥10%, n=45). Nonculprit coronary plaque features were compared among the 3 groups. Results: A total of 448 nonculprit plaques were identified (lower FRS, n=61; intermediate FRS, n=267; higher FRS, n=120). Compared to the patients with lower and intermediated FRS, those with higher FRS were older (p<0.001), and more likely to have male gender (p<0.001), diabetes (p=0.023), lower HDL-cholesterol (p<0.001) and higher creatinine levels (p=0.023). Compared to the patients with lower FRS, those with higher FRS had greater lipid index (mean lipid arc x lipid length), and tended to have higher prevalence of thin-cap fibroatheroma (TCFA). Patients with higher FRS showed greater prevalence of calcifications compared to those with lower and intermediate FRS. Prevalence of cholesterol crystals was progressively higher across the 3 groups. At multivariate analysis, presentation with ACS (OR, 2.37; 95% CI, 1.27–4.39; p=0.006), and FRS (OR, 1.57 per 5% risk increase; 95% CI, 1.01–2.42, p=0.043) were independent predictors of TCFA. Conclusions: Nonculprit plaques of patients with higher FRS showed greater lipid content, and higher prevalence of calcifications and cholesterol crystals compared to those of patients with lower and intermediate FRS. ACS presentation and FRS were independent predictors of TCFA.

Associations between the Framingham Risk Score and coronary plaque characteristics as assessed by three-vessel optical coherence tomography

2016 ◽  
Vol 27 (6) ◽  
pp. 460-466 ◽  
Author(s):  
Rocco Vergallo ◽  
Lei Xing ◽  
Yoshiyasu Minami ◽  
Tsunenari Soeda ◽  
Daniel S. Ong ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Coronary Plaque ◽  
Optical Coherence ◽  
Framingham Risk

scholarly journals Correlation of Serum Uric Acid Levels with Nonculprit Plaque Instability in Patients with Acute Coronary Syndromes: A 3-Vessel Optical Coherence Tomography Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Donghui Zhang ◽  
Ruoxi Zhang ◽  
Ning Wang ◽  
Lin Lin ◽  
Bo Yu
Keyword(s):  
Optical Coherence Tomography ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Elevated Serum ◽  
Coronary Plaque ◽  
Optical Coherence ◽  
Plaque Instability ◽  
Coronary Syndrome ◽  
Fibrous Cap ◽  
Coronary Syndromes

Elevated serum uric acid (SUA) level is known to be a prognostic factor in patients with acute coronary syndrome (ACS). However, the correlation between SUA level and coronary plaque instability has not been fully evaluated. The aim of this study was to investigate the association between SUA level and plaque instability of nonculprit lesions in patients with ACS using optical coherence tomography. A total of 150 patients with ACS who underwent 3-vessel optical coherence tomography were selected. Patients were classified into 3 groups according to tertiles of SUA level. There was a trend towards a thinner fibrous cap (0.15 ± 0.06 versus 0.07 ± 0.01 versus 0.04 ± 0.01 mm2, p<0.001) and a wider mean lipid arc (169.41 ± 33.16 versus 177.22 ± 37.76 versus 222.43 ± 47.65°, p<0.001) with increasing SUA tertile. The plaques of the high and intermediate tertile groups had a smaller minimum lumen area than the low tertile group (6.02 ± 1.11 versus 5.38 ± 1.28 mm2, p<0.001). In addition, thin-cap fibroatheromas, microvessels, macrophages, and cholesterol crystals were more frequent in the high tertile group than the low and intermediate groups. Multivariate analysis showed SUA level to be a predictor of plaque instability.

scholarly journals Intrinsic calcification angle: a novel feature of the vulnerable coronary plaque in patients with type 2 diabetes: an optical coherence tomography study

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Sebastian Reith ◽  
Andrea Milzi ◽  
Enrico Domenico Lemma ◽  
Rosalia Dettori ◽  
Kathrin Burgmaier ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Optical Coherence Tomography ◽  
Finite Elements ◽  
Coronary Plaque ◽  
Optical Coherence ◽  
Plaque Vulnerability ◽  
Finite Elements Analysis ◽  
Coronary Syndrome ◽  
Fibrous Cap

Abstract Background Coronary calcification is associated with high risk for cardiovascular events. However, its impact on plaque vulnerability is incompletely understood. In the present study we defined the intrinsic calcification angle (ICA) as the angle externally projected by a vascular calcification and analyzed its role as novel feature of coronary plaque vulnerability in patients with type 2 diabetes. Methods Optical coherence tomography was used to determine ICA in 219 calcifications from 56 patients with stable coronary artery disease (CAD) and 143 calcifications from 36 patients with acute coronary syndrome (ACS). We then used finite elements analysis to gain mechanistic insight into the effects of ICA. Results Minimal (139.8 ± 32.8° vs. 165.6 ± 21.6°, p < 0.001) and mean ICA (164.1 ± 14.3° vs. 176.0 ± 8.4°, p < 0.001) were lower in ACS vs. stable CAD patients. Mean ICA predicted ACS with very good diagnostic efficiency (AUC = 0.840, 95% CI 0.797–0.882, p < 0.001, optimal cut-off 175.9°); younger age (OR 0.95 per year, 95% CI 0.92–0.98, p = 0.002), male sex (OR 2.18, 95% CI 1.41–3.38, p < 0.001), lower HDL-cholesterol (OR 0.82 per 10 mg/dl, 95% CI 0.68–0.98, p = 0.029) and ACS (OR 14.71, 95% CI 8.47–25.64, p < 0.001) were determinants of ICA < 175.9°. A lower ICA predicted ACS (OR for 10°-variation 0.25, 95% CI 0.13–0.52, p < 0.001) independently from fibrous cap thickness, presence of macrophages or extension of lipid core. In finite elements analysis we confirmed that lower ICA causes increased stress on a lesion’s fibrous cap; this effect was potentiated in more superficial calcifications and adds to the destabilizing role of smaller calcifications. Conclusion Our clinical and mechanistic data for the first time identify ICA as a novel feature of coronary plaque vulnerability.

Optical Coherence Tomography-Based Patient-Specific Residual Multi-Thrombus Coronary Plaque Models with Fluid-Structure Interaction for Better Treatment Decisions: A Biomechanical Modeling Case Study

2021 ◽  
Author(s):  
Liang Wang ◽  
Luping He ◽  
Haibo Jia ◽  
Rui Lv ◽  
Xiaoya Guo ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Solid Mechanics ◽  
Treatment Plan ◽  
Specific Treatment ◽  
Coronary Plaque ◽  
Patient Specific ◽  
Optical Coherence ◽  
Aspiration Thrombectomy ◽  
Coronary Syndrome ◽  
Residual Thrombus

Abstract Intracoronary thrombus from plaque erosion could cause fatal acute coronary syndrome (ACS). A conservative anti-thrombotic therapy has been proposed to treat ACS patients in lieu of stenting. It is speculated that the residual thrombus after aspiration thrombectomy would influence the prognosis of this treatment. However, biomechanical mechanisms affecting intracoronary thrombus remodeling and clinical outcome remain largely unknown. In vivo optical coherence tomography (OCT) data of a coronary plaque with two residual thrombi after anti-thrombotic therapy were acquired from an ACS patient with consent obtained. Three OCT-based FSI models with different thrombus volumes, fluid-only and structure-only models were constructed to simulate and compare the biomechanical interplay among blood flow, residual thrombus and vessel wall mimicking different clinical situations. Our results showed that residual thrombus would decrease coronary volumetric flow rate by 9.3%, but elevate wall shear stress (WSS) by 29.4% and 75.5% at Thrombus 1 & 2, respectively. WSS variations in a cardiac cycle from structure-only model were 12.1% and 13.5% higher at the two thrombus surfaces than those from FSI model. Intracoronary thrombi were subjected to compressive forces indicated by negative thrombus stress. Tandem intracoronary thrombus might influence coronary hemodynamics and solid mechanics differently. Computational modeling could be used to quantify biomechanical conditions under which patients could receive patient-specific treatment plan with optimized outcome after anti-thrombotic therapy. More patient studies with follow-up data are needed to continue the investigation and better understand mechanisms governing thrombus remodeling process.

scholarly journals New Insights into the Association between Fibrinogen and Coronary Atherosclerotic Plaque Vulnerability: An Intravascular Optical Coherence Tomography Study

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Jun Wang ◽  
Lu Jia ◽  
Xing Li ◽  
Siyu Jin ◽  
Xiaomei Li ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Optical Coherence Tomography ◽  
Heart Disease ◽  
Plaque Rupture ◽  
Experimental Studies ◽  
High Body Mass Index ◽  
Coronary Plaque ◽  
Optical Coherence ◽  
Plaque Vulnerability ◽  
Coronary Syndrome

Background. Fibrinogen levels have been associated with coronary plaque vulnerability in experimental studies. However, it has yet to be determined if serum fibrinogen levels are independently associated with coronary plaque vulnerability as detected by optical coherence tomography (OCT) in patients with coronary heart disease. Methods. Patients with coronary heart disease (CHD) who underwent coronary angiography and OCT in our department from January 2015 to August 2018 were included in this study. Coronary lesions were categorized as ruptured plaque, nonruptured with thin-cap fibroatheroma (TCFA), and nonruptured and non-TCFA. Presence of ruptured plaque and nonruptured with TCFA was considered to be vulnerable lesions. Determinants of coronary vulnerability were evaluated by multivariable logistic regression analyses. Results. A total of 154 patients were included in this study; 17 patients had ruptured plaques, 15 had nonruptured plaques with TCFA, and 122 had nonruptured plaques with non-TCFA. Results of univariate analyses showed that being male, diabetes, current smoking, high body mass index (BMI), and clinical diagnosis of acute coronary syndrome (ACS) were associated with coronary vulnerability. No significant differences were detected in patient characteristics, coronary angiographic findings, and OCT results between patients with higher and normal fibrinogen. Results of multivariate logistic analyses showed that diabetes and ACS were associated with TCFA, while diabetes, higher BMI, and ACS were associated with plaque rupture. Conclusions. Diabetes, higher BMI, and ACS are independently associated with coronary vulnerability as detected by OCT. Serum fibrinogen was not associated with coronary vulnerability in our cohort.

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