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Frequency, Predictors, Distribution, and Morphological Characteristics of Layered Culprit and Nonculprit Plaques of Patients With Acute Myocardial Infarction: In Vivo 3-Vessel Optical Coherence Tomography Study.
Dai, Jiannan; Fang, Chao; Zhang, Shaotao; Li, Lulu; Wang, Yini; Xing, Lei; Yu, Huai; Jiang, Senqing; Yin, Yanwei; Wang, Jifei; Wang, Yidan; Guo, Junchen; Lei, Fangmeng; Liu, Huimin; Xu, Maoen; Ren, Xuefeng; Ma, Lijia; Wei, Guo; Zhang, Shaosong; Hou, Jingbo; Mintz, Gary S; Yu, Bo.
Afiliação
  • Dai J; Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, China (J.D., C.F., S. Zhang, L.L., Yini Wang, L.X., H.Y., S.J., Y.Y., J.W., Yidan Wang, J.G., F.L., H.L., M.X., X.R., L.M., G.W., S. Zhang, J.
  • Fang C; Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, China (J.D., C.F., S. Zhang, L.L., Yini Wang, L.X., H.Y., S.J., Y.Y., J.W., Yidan Wang, J.G., F.L., H.L., M.X., X.R., L.M., G.W., S. Zhang, J.
  • Zhang S; Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, China (J.D., C.F., S. Zhang, L.L., Yini Wang, L.X., H.Y., S.J., Y.Y., J.W., Yidan Wang, J.G., F.L., H.L., M.X., X.R., L.M., G.W., S. Zhang, J.
  • Li L; Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, China (J.D., C.F., S. Zhang, L.L., Yini Wang, L.X., H.Y., S.J., Y.Y., J.W., Yidan Wang, J.G., F.L., H.L., M.X., X.R., L.M., G.W., S. Zhang, J.
  • Wang Y; Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, China (J.D., C.F., S. Zhang, L.L., Yini Wang, L.X., H.Y., S.J., Y.Y., J.W., Yidan Wang, J.G., F.L., H.L., M.X., X.R., L.M., G.W., S. Zhang, J.
  • Xing L; Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, China (J.D., C.F., S. Zhang, L.L., Yini Wang, L.X., H.Y., S.J., Y.Y., J.W., Yidan Wang, J.G., F.L., H.L., M.X., X.R., L.M., G.W., S. Zhang, J.
  • Yu H; Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, China (J.D., C.F., S. Zhang, L.L., Yini Wang, L.X., H.Y., S.J., Y.Y., J.W., Yidan Wang, J.G., F.L., H.L., M.X., X.R., L.M., G.W., S. Zhang, J.
  • Jiang S; Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, China (J.D., C.F., S. Zhang, L.L., Yini Wang, L.X., H.Y., S.J., Y.Y., J.W., Yidan Wang, J.G., F.L., H.L., M.X., X.R., L.M., G.W., S. Zhang, J.
  • Yin Y; Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, China (J.D., C.F., S. Zhang, L.L., Yini Wang, L.X., H.Y., S.J., Y.Y., J.W., Yidan Wang, J.G., F.L., H.L., M.X., X.R., L.M., G.W., S. Zhang, J.
  • Wang J; Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, China (J.D., C.F., S. Zhang, L.L., Yini Wang, L.X., H.Y., S.J., Y.Y., J.W., Yidan Wang, J.G., F.L., H.L., M.X., X.R., L.M., G.W., S. Zhang, J.
  • Wang Y; Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, China (J.D., C.F., S. Zhang, L.L., Yini Wang, L.X., H.Y., S.J., Y.Y., J.W., Yidan Wang, J.G., F.L., H.L., M.X., X.R., L.M., G.W., S. Zhang, J.
  • Guo J; Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, China (J.D., C.F., S. Zhang, L.L., Yini Wang, L.X., H.Y., S.J., Y.Y., J.W., Yidan Wang, J.G., F.L., H.L., M.X., X.R., L.M., G.W., S. Zhang, J.
  • Lei F; Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, China (J.D., C.F., S. Zhang, L.L., Yini Wang, L.X., H.Y., S.J., Y.Y., J.W., Yidan Wang, J.G., F.L., H.L., M.X., X.R., L.M., G.W., S. Zhang, J.
  • Liu H; Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, China (J.D., C.F., S. Zhang, L.L., Yini Wang, L.X., H.Y., S.J., Y.Y., J.W., Yidan Wang, J.G., F.L., H.L., M.X., X.R., L.M., G.W., S. Zhang, J.
  • Xu M; Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, China (J.D., C.F., S. Zhang, L.L., Yini Wang, L.X., H.Y., S.J., Y.Y., J.W., Yidan Wang, J.G., F.L., H.L., M.X., X.R., L.M., G.W., S. Zhang, J.
  • Ren X; Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, China (J.D., C.F., S. Zhang, L.L., Yini Wang, L.X., H.Y., S.J., Y.Y., J.W., Yidan Wang, J.G., F.L., H.L., M.X., X.R., L.M., G.W., S. Zhang, J.
  • Ma L; Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, China (J.D., C.F., S. Zhang, L.L., Yini Wang, L.X., H.Y., S.J., Y.Y., J.W., Yidan Wang, J.G., F.L., H.L., M.X., X.R., L.M., G.W., S. Zhang, J.
  • Wei G; Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, China (J.D., C.F., S. Zhang, L.L., Yini Wang, L.X., H.Y., S.J., Y.Y., J.W., Yidan Wang, J.G., F.L., H.L., M.X., X.R., L.M., G.W., S. Zhang, J.
  • Zhang S; Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, China (J.D., C.F., S. Zhang, L.L., Yini Wang, L.X., H.Y., S.J., Y.Y., J.W., Yidan Wang, J.G., F.L., H.L., M.X., X.R., L.M., G.W., S. Zhang, J.
  • Hou J; Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, China (J.D., C.F., S. Zhang, L.L., Yini Wang, L.X., H.Y., S.J., Y.Y., J.W., Yidan Wang, J.G., F.L., H.L., M.X., X.R., L.M., G.W., S. Zhang, J.
  • Mintz GS; Cardiovascular Research Foundation, NY (G.S.M.).
  • Yu B; Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, China (J.D., C.F., S. Zhang, L.L., Yini Wang, L.X., H.Y., S.J., Y.Y., J.W., Yidan Wang, J.G., F.L., H.L., M.X., X.R., L.M., G.W., S. Zhang, J.
Circ Cardiovasc Interv ; 13(10): e009125, 2020 10.
Article em En | MEDLINE | ID: mdl-32957793
ABSTRACT

BACKGROUND:

Subclinical atherothrombosis and plaque healing may lead to rapid plaque progression. The histopathologic healed plaque has a layered appearance when imaged using optical coherence tomography. We assessed the frequency, predictors, distribution, and morphological characteristics of optical coherence tomography layered culprit and nonculprit plaques in patients with acute myocardial infarction.

METHODS:

A prospective series of 325 patients with acute myocardial infarction underwent optical coherence tomography imaging of all 3 native coronary arteries. Layered plaque phenotype had heterogeneous signal-rich layered tissue located close to the luminal surface that was clearly demarcated from the underlying plaque.

RESULTS:

Layered plaques were detected in 74.5% of patients with acute myocardial infarction. Patients with layered culprit plaques had more layered nonculprit plaques; and they more often had preinfarction angina, ST-segment-elevation myocardial infarction, higher low-density lipoprotein cholesterol, and absence of antiplatelet therapy. Layered plaques tended to cluster in the proximal segment of the left anterior descending artery and left circumflex artery but were more uniformly distributed in the right coronary artery. As compared with nonlayered plaques, layered plaques had greater optical coherence tomography lumen area stenosis at both culprit and nonculprit sites. The frequency of layered plaque phenotype (P=0.038) and maximum area of layered tissue (P<0.001) increased from nonculprit thin-cap fibroatheromas to nonculprit ruptures to culprit ruptures.

CONCLUSIONS:

Layered plaques were identified in 3-quarters of patients with acute myocardial infarction, especially in the culprit plaques of patients with ST-segment-elevation myocardial infarction. Layered plaques had a limited, focal distribution in the left anterior descending artery, and left circumflex artery but were more evenly distributed in the right coronary artery and were characterized by greater lumen narrowing at both culprit and nonculprit sites. Graphic Abstract A graphic abstract is available for this article.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doença da Artéria Coronariana / Vasos Coronários / Tomografia de Coerência Óptica / Placa Aterosclerótica / Infarto do Miocárdio Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2020 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doença da Artéria Coronariana / Vasos Coronários / Tomografia de Coerência Óptica / Placa Aterosclerótica / Infarto do Miocárdio Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2020 Tipo de documento: Article