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Distinctive Morphological Patterns of Complicated Coronary Plaques in Acute Coronary Syndromes: Insights from an Optical Coherence Tomography Study

Optical coherence tomography (OCT) is an ideal imaging technique for assessing culprit coronary plaque anatomy. We investigated the morphological features and mechanisms leading to plaque complication in a single-center observational retrospective study on 70 consecutive patients with an established...

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Autores principales: Onea, Horea-Laurentiu, Spinu, Mihail, Homorodean, Calin, Olinic, Maria, Lazar, Florin-Leontin, Ober, Mihai Claudiu, Stoian, Diana, Itu, Lucian Mihai, Olinic, Dan Mircea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9689106/
https://www.ncbi.nlm.nih.gov/pubmed/36428897
http://dx.doi.org/10.3390/diagnostics12112837
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author Onea, Horea-Laurentiu
Spinu, Mihail
Homorodean, Calin
Olinic, Maria
Lazar, Florin-Leontin
Ober, Mihai Claudiu
Stoian, Diana
Itu, Lucian Mihai
Olinic, Dan Mircea
author_facet Onea, Horea-Laurentiu
Spinu, Mihail
Homorodean, Calin
Olinic, Maria
Lazar, Florin-Leontin
Ober, Mihai Claudiu
Stoian, Diana
Itu, Lucian Mihai
Olinic, Dan Mircea
author_sort Onea, Horea-Laurentiu
collection PubMed
description Optical coherence tomography (OCT) is an ideal imaging technique for assessing culprit coronary plaque anatomy. We investigated the morphological features and mechanisms leading to plaque complication in a single-center observational retrospective study on 70 consecutive patients with an established diagnosis of acute coronary syndrome (ACS) who underwent OCT imaging after coronary angiography. Three prominent morphological entities were identified. Type I or intimal discontinuity, which was found to be the most common mechanism leading to ACS and was seen in 35 patients (50%), was associated with thrombus (68.6%; p = 0.001), mostly affected the proximal plaque segment (60%; p = 0.009), and had no distinctive underlying plaque features. Type II, a significant stenosis with vulnerability features (inflammation in 16 patients, 84.2%; thin-cap fibroatheroma (TCFA) in 10 patients, 52.6%) and a strong association with lipid-rich plaques (94.7%; p = 0.002), was observed in 19 patients (27.1%). Type III, a protrusive calcified nodule, which was found to be the dominant morphological pattern in 16 patients (22.9%), was found in longer plaques (20.8 mm vs. 16.8 mm ID vs. 12.4 mm SS; p = 0.04) and correlated well with TCFA (93.8%; p = 0.02) and inflammation (81.3%). These results emphasize the existence of a wide spectrum of coronary morphological patterns related to ACS.
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spelling pubmed-96891062022-11-25 Distinctive Morphological Patterns of Complicated Coronary Plaques in Acute Coronary Syndromes: Insights from an Optical Coherence Tomography Study Onea, Horea-Laurentiu Spinu, Mihail Homorodean, Calin Olinic, Maria Lazar, Florin-Leontin Ober, Mihai Claudiu Stoian, Diana Itu, Lucian Mihai Olinic, Dan Mircea Diagnostics (Basel) Article Optical coherence tomography (OCT) is an ideal imaging technique for assessing culprit coronary plaque anatomy. We investigated the morphological features and mechanisms leading to plaque complication in a single-center observational retrospective study on 70 consecutive patients with an established diagnosis of acute coronary syndrome (ACS) who underwent OCT imaging after coronary angiography. Three prominent morphological entities were identified. Type I or intimal discontinuity, which was found to be the most common mechanism leading to ACS and was seen in 35 patients (50%), was associated with thrombus (68.6%; p = 0.001), mostly affected the proximal plaque segment (60%; p = 0.009), and had no distinctive underlying plaque features. Type II, a significant stenosis with vulnerability features (inflammation in 16 patients, 84.2%; thin-cap fibroatheroma (TCFA) in 10 patients, 52.6%) and a strong association with lipid-rich plaques (94.7%; p = 0.002), was observed in 19 patients (27.1%). Type III, a protrusive calcified nodule, which was found to be the dominant morphological pattern in 16 patients (22.9%), was found in longer plaques (20.8 mm vs. 16.8 mm ID vs. 12.4 mm SS; p = 0.04) and correlated well with TCFA (93.8%; p = 0.02) and inflammation (81.3%). These results emphasize the existence of a wide spectrum of coronary morphological patterns related to ACS. MDPI 2022-11-17 /pmc/articles/PMC9689106/ /pubmed/36428897 http://dx.doi.org/10.3390/diagnostics12112837 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Onea, Horea-Laurentiu
Spinu, Mihail
Homorodean, Calin
Olinic, Maria
Lazar, Florin-Leontin
Ober, Mihai Claudiu
Stoian, Diana
Itu, Lucian Mihai
Olinic, Dan Mircea
Distinctive Morphological Patterns of Complicated Coronary Plaques in Acute Coronary Syndromes: Insights from an Optical Coherence Tomography Study
title Distinctive Morphological Patterns of Complicated Coronary Plaques in Acute Coronary Syndromes: Insights from an Optical Coherence Tomography Study
title_full Distinctive Morphological Patterns of Complicated Coronary Plaques in Acute Coronary Syndromes: Insights from an Optical Coherence Tomography Study
title_fullStr Distinctive Morphological Patterns of Complicated Coronary Plaques in Acute Coronary Syndromes: Insights from an Optical Coherence Tomography Study
title_full_unstemmed Distinctive Morphological Patterns of Complicated Coronary Plaques in Acute Coronary Syndromes: Insights from an Optical Coherence Tomography Study
title_short Distinctive Morphological Patterns of Complicated Coronary Plaques in Acute Coronary Syndromes: Insights from an Optical Coherence Tomography Study
title_sort distinctive morphological patterns of complicated coronary plaques in acute coronary syndromes: insights from an optical coherence tomography study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9689106/
https://www.ncbi.nlm.nih.gov/pubmed/36428897
http://dx.doi.org/10.3390/diagnostics12112837
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