Predictors for layered coronary plaques: an optical coherence tomography study
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Predictors for layered coronary plaques: an optical coherence tomography study Makoto Araki1,2 · Taishi Yonetsu2 · Michele Russo1 · Osamu Kurihara1 · Hyung Oh Kim1 · Hiroki Shinohara1 · Vikas Thondapu1 · Tsunenari Soeda3 · Yoshiyasu Minami4 · Takumi Higuma5 · Hang Lee6 · Tsunekazu Kakuta7 · Ik‑Kyung Jang1,8
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Healed coronary plaques, morphologically characterized by a layered pattern, are signatures of previous plaque disruption and healing. Recent optical coherence tomography (OCT) studies showed that layered plaque is associated with vascular vulnerability. However, factors associated with layered plaques have not been studied. The aim of this study was to investigate predictors for layered plaque at the culprit plaques and at non-culprit plaques. Patients with coronary artery disease who underwent pre-intervention OCT imaging of the culprit lesion were included. Layered plaques were defined as plaques with one or more layers of different optical density and a clear demarcation from underlying components. Among 313 patients, layered plaque at the culprit lesion was observed in 18.8% of ST-segment elevation myocardial infarction patients, 36.3% of non-ST-segment elevation acute coronary syndrome patients, and 53.4% of stable angina pectoris (SAP) patients (p 70% were independent predictors for layered plaque at the culprit lesion. In addition, 394 non-culprit plaques in 190 patients were assessed to explore predictors for layered plaques at non-culprit lesions. SAP, and thin-cap fibroatheroma and layered plaque at the culprit lesion were independent predictors for layered plaques at non-culprit lesions. In conclusion, clinical presentation of SAP was a strong predictor for layered plaque at both culprit plaques and non-culprit plaques. Development and biologic significance of layered plaques may be related to a balance between pan-vascular vulnerability and endogenous anti-thrombotic protective mechanism. Keywords Layered plaque · Healed plaque · Optical coherence tomography · Predictor · Stable angina pectoris
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11239-020-02116-5) contains supplementary material, which is available to authorized users. * Taishi Yonetsu [email protected]
4
Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
* Ik‑Kyung Jang [email protected]
5
Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
6
Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
7
Department of Cardiology, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan
8
Division of Cardiology, Kyung Hee University Hospital, Seoul, South Korea
1
Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 800, Boston, MA 02114, USA
Department of Int
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