scholarly journals A Novel Monocyte Subset as a Unique Signature of Atherosclerotic Plaque Rupture

2021 ◽  
Vol 9 ◽  
Author(s):  
Ramona Vinci ◽  
Daniela Pedicino ◽  
Alice Bonanni ◽  
Alessia D’Aiello ◽  
Anna Severino ◽  
...  
Keyword(s):  
Cell Culture ◽  
Atherosclerotic Plaque ◽  
Coronary Plaque ◽  
Plaque Morphology ◽  
Monocyte Subset ◽  
Pathophysiological Mechanism ◽  
Monocyte Subsets ◽  
Coronary Syndrome ◽  
Plaque Erosion ◽  
Culture Supernatants

The evaluation of monocyte subset distribution among acute coronary syndrome (ACS) patients according to culprit coronary plaque morphology has never been explored. We evaluated whether there were significant differences in frequency of circulating monocyte subsets isolated from ACS patients according to optical coherence tomography (OCT) investigation of plaque erosion and rupture. We enrolled 74 patients with non-ST-elevation ACS (NSTE-ACS), 21 of them underwent OCT investigation of the culprit coronary plaque and local macrophage infiltration (MØI) assessment. As control, we enrolled 30 chronic coronary syndrome (CCS) patients. We assessed the frequency of monocyte subsets in the whole study population, in reliance on their CD14 and CD16 expression (classical, CM: CD14++CD16–; intermediates, IM: CD14++CD16+; non-classical, NCM: CD14+CD16++). Then, we tested the effect of lipopolysaccharide (LPS) (a CD14 ligand) on peripheral blood mononuclear cells (PBMCs) of NSTE-ACS patients, quantifying the inflammatory cytokine levels in cell-culture supernatants. Our data proved that monocyte subsets isolated from NSTE-ACS patients represent a peculiar biological signature of the pathophysiological mechanism lying beneath atherosclerotic plaque with a ruptured fibrous cap (RFC) as compared with plaque erosion. Moreover, the magnitude of LPS-mediated effects on IL-1β, IL-6, and IL-10 cytokine release in cell-culture supernatants appeared to be greater in NSTE-ACS patients with RFC. Finally, we described a fourth monocyte population never explored before in this clinical setting (pre-classical monocytes, PCM: CD14+CD16–) that was prevalent in NSTE-ACS patients as compared with CCS and, especially, in patients with RFC and culprit plaque with MØI.

Abstract 681: Characteristics of Atherosclerotic Plaque Burden in Patients With and Without Acute Coronary Syndrome Presenting With Acute Chest Pain to the Emergency Department

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Fabian Bamberg ◽  
Maros Ferecik ◽  
Quynh Truong ◽  
Ian Rogers ◽  
Michael Shapiro ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Coronary Arteries ◽  
Atherosclerotic Plaque ◽  
Acute Chest Pain ◽  
Coronary Plaque ◽  
Plaque Burden ◽  
Coronary Syndrome ◽  
Coronary Ct ◽  
Calcified Plaque

Background: Coronary computed tomography (CT) may improve the early triage of patients with acute chest pain in the emergency department (ED). The aim of this study was to compare the presence and extent of coronary atherosclerotic plaque as detected by coronary CT in patients with and without acute coronary syndromes (ACS). Methods: The study was designed as a prospective, observational cohort study in patients with acute chest pain but negative cardiac biomarkers and no diagnostic ECG changes, admitted to rule out myocardial ischemia. All patients underwent coronary CT prior to hospital admission. The presence of coronary plaque was treated as a dichotomous outcome, and the extent of CAD was defined as number of (1) coronary segments with plaque, or (2) major coronary arteries with plaque detected by MDCT as assessed by two independent observers. The clinical outcome (ACS) was adjudicated by a review committee using established AHA criteria; subjects with history of CAD (stent placement, bypass) were excluded. Results : Among 368 patients with acute chest pain (mean age 53±12 years, 61% male) 31 patients were determined to have ACS (8%). None of the 183 subjects without plaque (50%) had an ACS. Among the remaining 185 subjects (mean age 58.0±11.5 years, 68% male) in whom coronary plaque was detected, patients with ACS had a significantly more plaque (7.2±3.7 vs. 4.2±3.4, p<0.0001 segments) as compared to subjects without ACS. Similar results were seen for calcified plaque and non-calcified plaque (6.5±3.7 vs. 3.6±3.5 segments, p<0.0001; and 3.6±3.2 vs. 1.8±2.2 segments, p<0.0001, respectively). In addition, the rate of ACS increased with the number of major coronary arteries with plaque (1-vessel: 6.8%, 2-vessels: 10.6%, 3 vessels: 30.8%, and 4-vessels: 25%; p<0.01). In contrast, the ratio of non-calcified to calcified plaque was not different between patients with and without ACS (0.68±0.6 vs. 0.54±0.72, p=0.31). Conclusions: The extent of coronary plaque differs between subjects with and without ACS among patients presenting with acute chest pain. Detailed assessment of the extent and composition of coronary plaque may be helpful to assess risk of ACS among patients with acute chest pain but inconclusive initial ED evaluation.

scholarly journals The use of optical coherent tomography for diagnostics of the coronary plaque structure

2017 ◽  
Vol 95 (8) ◽  
pp. 687-692
Author(s):  
I. A. Mustafina ◽  
Naufal Sh. Zagidullin ◽  
V. N. Palvov ◽  
V. Sh. Ishmetov ◽  
H. Jia ◽  
...  
Keyword(s):  
Vulnerable Plaque ◽  
Coronary Plaque ◽  
Plaque Morphology ◽  
Intravascular Imaging ◽  
Resolution Method ◽  
Coronary Syndrome ◽  
Invasive Cardiology ◽  
Basic Characteristics ◽  
Technical Features ◽  
High Resolution Method

Optical coherence tomography (OCT) is a high-resolution method for intravascular imaging of coronary arteries based on interferometry. This review presents technical features of OCT systems and basic characteristics of OCT images with reference to its diagnosis value for the study of atherosclerosis in comparison with intravascular ultrasound. The experience with detection of vulnerable plaque and elucidation of plaque morphology as a mechanism of acute coronary syndrome is analyzed. This review focuses on the applicability of OCT to research and clinical practice in the field of invasive cardiology.

Macrophage infiltrates in coronary plaque erosion and cardiovascular outcome in patients with acute coronary syndrome

2020 ◽  
Vol 311 ◽  
pp. 158-166 ◽  
Author(s):  
Rocco A. Montone ◽  
Vincenzo Vetrugno ◽  
Massimiliano Camilli ◽  
Michele Russo ◽  
Francesco Fracassi ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Plaque ◽  
Cardiovascular Outcome ◽  
Coronary Syndrome ◽  
Plaque Erosion

Abstract 17826: Age Difference in Plaque Characteristics of Culprit Lesions in Patients with Acute Coronary Syndrome: an Optical Coherence Tomography Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Haibo Jia ◽  
Sining Hu ◽  
Tsunenari Soeda ◽  
Rocco Vergallo ◽  
Yoshiyasu Minami ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Plaque Rupture ◽  
Plaque Morphology ◽  
Age Difference ◽  
Age Group ◽  
Coronary Syndrome ◽  
Plaque Erosion ◽  
Younger Age ◽  
Group A ◽  
Group B

Introduction: The relationship between age and culprit plaque characteristics in patients with acute coronary syndrome (ACS) has not been reported. Hypothesis: The characteristics of the culprit plaques differ between younger population and older population with ACS. Methods: We studied 154 patients with ACS who underwent OCT imaging before intervention. The distribution and plaque morphology of the culprit lesion were compared according to the age: Group A (65 years, n=44). Results: There were more smokers in Group A than in Group B and C (58.3% vs. 36.5% vs. 15.9%, p<0.001). Plaque erosion was more frequently observed in the younger age group, whereas plaque rupture was more frequent in the older age group (Figure). The prevalence of calcified nodule was not different among the three groups (Figure). Other features of thin-cap fibroatheroma, thrombus, and macrophage infiltration showed no differences among the three groups. Conclusions: Plaque erosion was the primary cause for ACS in younger patients, whereas plaque rupture was more commonly observed in older patients.

scholarly journals Relationship between monocyte-to-lymphocyte ratio and coronary plaque vulnerability in patients with acute coronary syndrome: an optical coherence tomography study

2019 ◽  
Author(s):  
Ting-yu Zhang ◽  
Qi Zhao ◽  
Ze-sen Liu ◽  
Chao-yi Zhang ◽  
Jie Yang ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Acute Coronary Syndrome ◽  
Plaque Rupture ◽  
Coronary Plaque ◽  
Plaque Morphology ◽  
Multivariable Logistic Regression Analysis ◽  
Optical Coherence ◽  
Plaque Vulnerability ◽  
Lymphocyte Ratio ◽  
Coronary Syndrome

Abstract Background The importance of monocyte-to-lymphocyte ratio (MLR) has been indicated in the initiation and progression of coronary artery disease (CAD). However, few previous researches demonstrated the relationship between MLR and plaque vulnerability. We aimed to investigate coronary plaque vulnerability in patients with acute coronary syndrome (ACS) by optical coherence tomography (OCT). Methods A total of 72 ACS patients who underwent coronary angiography and OCT test in Beijing Anzhen hospital were included in this retrospective study. The plaque vulnerability and plaque morphology were assessed by OCT. Results The coronary plaque in high MLR group exhibited more vulnerable features, characterizing as thinner thickness of fibrous cap (FCT)(112.37 ± 60.24 vs 153.49 ± 73.29 μm, P = 0.013), greater maximum lipid core angle (167.36 ± 62.33 vs 138.79 ± 56.37°, P = 0.010) and longer lipid plaque length (6.34 ± 3.12 vs 4.50 ± 2.21mm, P = 0.041). A prominently negative liner relation was found between MLR and FCT (R = 0.225, P < 0.005). Meanwhile, the incidence of OCT-detected thin cap fibro-atheroma (TCFA) (44.7% vs 18.4%, P = 0.014) and plaque rupture (36.8% vs 13.2%, P = 0.017) were higher in high MLR group. Most importantly, multivariable logistic regression analysis showed MLR level was related to the presence of TCFA (OR:3.316，95%：1.448-7.593，P = 0.005). MLR level could differentiate TCFA with a sensitivity of 72.0% and a specificity of 66.1%. Conclusion Circulating MLR level has potential value in identifying the presence of vulnerable plaque in patients with ACS. MLR, as a non- invasive biomarker of inflammation, may be valuable in revealing plaque vulnerability. Key words Monocyte-to-lymphocyte ratio, Optical coherence tomography, Plaque vulnerability

Analysis of Biomechanical Forces Influencing Atherosclerotic Plaque Vulnerability

2009 ◽  
Author(s):  
Ze’ev Aronis ◽  
Shmuel Einav
Keyword(s):  
Atherosclerotic Plaque ◽  
Intraplaque Hemorrhage ◽  
Western World ◽  
Plaque Morphology ◽  
Rapid Progression ◽  
Heart Attacks ◽  
Coronary Syndrome ◽  
Fibrous Cap ◽  
Life Threatening ◽  
Biomechanical Forces

Cardiovascular disease has long been the leading cause of death in the western world: over 1.4 million heart attacks are suffered every year, more than half of which prove fatal. Vulnerable plaques are inflamed, active, and growing lesions which are prone to complications such as rupture, luminal and mural thrombosis, intraplaque hemorrhage, and rapid progression to stenosis. The rupture of thin fibrous cap overlying the necrotic core of a vulnerable plaque is the principal cause of acute coronary syndrome. The mechanism or mechanisms responsible for the sudden conversion of a stable atherosclerotic plaque to a life threatening athero-thrombotic lesion are not fully understood. It has been widely assumed that plaque morphology is the major determinant of clinical outcome [1, 2].

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