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12.05.2020 | Ausgabe 4/2020

Journal of Thrombosis and Thrombolysis 4/2020

Clinical significance of healed plaque detected by optical coherence tomography: a 2-year follow-up study

Zeitschrift:
Journal of Thrombosis and Thrombolysis > Ausgabe 4/2020
Autoren:
Osamu Kurihara, Michele Russo, Hyung Oh Kim, Makoto Araki, Hiroki Shinohara, Hang Lee, Masamichi Takano, Kyoichi Mizuno, Ik-Kyung Jang
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s11239-020-02076-w) contains supplementary material, which is available to authorized users.

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Abstract

Recent studies have shown that healed plaque at the culprit lesion detected by optical coherence tomography (OCT) is a sign of pan-vascular vulnerability and advanced atherosclerosis. However, the clinical significance of healed plaque is unknown. A total of 265 patients who had OCT imaging of a culprit vessel and 2-year clinical follow-up data were included. Patients were stratified based on the presence or absence of a layered plaque phenotype, defined as layers of different optical density by OCT at either culprit or non-culprit lesions. The association between layered plaque and major adverse cardiac events (MACE), defined as cardiac death, acute coronary syndromes (ACS), or revascularization, was studied. Among 265 patients, 96 (36.2%) had the layered plaque phenotype. Layered plaque was more frequently observed in stable angina pectoris patients than in ACS patients (57.8%vs. 25.1%, p < 0.001). The average clinical follow-up period was 672 ± 172 days. Cumulative MACE was significantly higher in patients with layered plaque (p = 0.041), which was primarily driven by the high revascularization rate at 2 years (p = 0.002). Multivariate regression analysis showed that presence of layered plaque and low-density lipoprotein cholesterol levels were independently associated with an increased risk of revascularization (p = 0.026, p = 0.008, respectively). Patients with healed plaque in the culprit vessel had a higher incidence of revascularization, as compared to those without healed plaque, at 2 years.

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