In vivo diagnosis of plaque erosion and calcified nodule in patients with acute coronary syndrome by intravascular optical coherence tomography

Haibo Jia, Farhad Abtahian, Aaron D. Aguirre, Stephen Lee, Stanley Chia, Harry Lowe, Koji Kato, Taishi Yonetsu, Rocco Vergallo, Sining Hu, Jinwei Tian, Hang Lee, Seung Jung Park, Yangsoo Jang, Owen C. Raffel, Kyoichi Mizuno, Shiro Uemura, Tomonori Itoh, Tsunekazu Kakuta, So Yeon Choi & 10 others Harold L. Dauerman, Abhiram Prasad, Catalin Toma, Iris McNulty, Shaosong Zhang, Bo Yu, Valentine Fuster, Jagat Narula, Renu Virmani, Ik Kyung Jang

Research output: Contribution to journalArticle

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Abstract

Objectives The aim of this study was to characterize the morphological features of plaque erosion and calcified nodule in patients with acute coronary syndrome (ACS) by optical coherence tomography (OCT). Background Plaque erosion and calcified nodule have not been systematically investigated in vivo. Methods A total of 126 patients with ACS who had undergone pre-intervention OCT imaging were included. The culprit lesions were classified as plaque rupture (PR), erosion (OCT-erosion), calcified nodule (OCT-CN), or with a new set of diagnostic criteria for OCT. Results The incidences of PR, OCT-erosion, and OCT-CN were 43.7%, 31.0%, and 7.9%, respectively. Patients with OCT-erosion were the youngest, compared with those with PR and OCT-CN (53.8 ± 13.1 years vs. 60.6 ± 11.5 years, 65.1 ± 5.0 years, p = 0.005). Compared with patients with PR, presentation with non-ST-segment elevation ACS was more common in patients with OCT-erosion (61.5% vs. 29.1%, p = 0.008) and OCT-CN (100% vs. 29.1%, p < 0.001). The OCT-erosion had a lower frequency of lipid plaque (43.6% vs. 100%, p < 0.001), thicker fibrous cap (169.3 ± 99.1 μm vs. 60.4 ± 16.6 μm, p < 0.001), and smaller lipid arc (202.8 ± 73.6 vs. 275.8 ± 60.4, p < 0.001) than PR. The diameter stenosis was least severe in OCT-erosion, followed by OCT-CN and PR (55.4 ± 14.7% vs. 66.1 ± 13.5% vs. 68.8 ± 12.9%, p < 0.001). Conclusions Optical coherence tomography is a promising modality for identifying OCT-erosion and OCT-CN in vivo. The OCT-erosion is a frequent finding in patients with ACS, especially in those with non-ST-segment elevation ACS and younger patients. The OCT-CN is the least common etiology for ACS and is more common in older patients. (The Massachusetts General Hospital Optical Coherence Tomography Registry; NCT01110538).

Original languageEnglish
Pages (from-to)1748-1758
Number of pages11
JournalJournal of the American College of Cardiology
Volume62
Issue number19
DOIs
Publication statusPublished - 2013 Nov 5

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Optical Coherence Tomography
Acute Coronary Syndrome
Rupture
Lipids

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Jia, Haibo ; Abtahian, Farhad ; Aguirre, Aaron D. ; Lee, Stephen ; Chia, Stanley ; Lowe, Harry ; Kato, Koji ; Yonetsu, Taishi ; Vergallo, Rocco ; Hu, Sining ; Tian, Jinwei ; Lee, Hang ; Park, Seung Jung ; Jang, Yangsoo ; Raffel, Owen C. ; Mizuno, Kyoichi ; Uemura, Shiro ; Itoh, Tomonori ; Kakuta, Tsunekazu ; Choi, So Yeon ; Dauerman, Harold L. ; Prasad, Abhiram ; Toma, Catalin ; McNulty, Iris ; Zhang, Shaosong ; Yu, Bo ; Fuster, Valentine ; Narula, Jagat ; Virmani, Renu ; Jang, Ik Kyung. / In vivo diagnosis of plaque erosion and calcified nodule in patients with acute coronary syndrome by intravascular optical coherence tomography. In: Journal of the American College of Cardiology. 2013 ; Vol. 62, No. 19. pp. 1748-1758.
@article{b24d89dcc7cb4f7d922a43ec2fd0aa45,
title = "In vivo diagnosis of plaque erosion and calcified nodule in patients with acute coronary syndrome by intravascular optical coherence tomography",
abstract = "Objectives The aim of this study was to characterize the morphological features of plaque erosion and calcified nodule in patients with acute coronary syndrome (ACS) by optical coherence tomography (OCT). Background Plaque erosion and calcified nodule have not been systematically investigated in vivo. Methods A total of 126 patients with ACS who had undergone pre-intervention OCT imaging were included. The culprit lesions were classified as plaque rupture (PR), erosion (OCT-erosion), calcified nodule (OCT-CN), or with a new set of diagnostic criteria for OCT. Results The incidences of PR, OCT-erosion, and OCT-CN were 43.7{\%}, 31.0{\%}, and 7.9{\%}, respectively. Patients with OCT-erosion were the youngest, compared with those with PR and OCT-CN (53.8 ± 13.1 years vs. 60.6 ± 11.5 years, 65.1 ± 5.0 years, p = 0.005). Compared with patients with PR, presentation with non-ST-segment elevation ACS was more common in patients with OCT-erosion (61.5{\%} vs. 29.1{\%}, p = 0.008) and OCT-CN (100{\%} vs. 29.1{\%}, p < 0.001). The OCT-erosion had a lower frequency of lipid plaque (43.6{\%} vs. 100{\%}, p < 0.001), thicker fibrous cap (169.3 ± 99.1 μm vs. 60.4 ± 16.6 μm, p < 0.001), and smaller lipid arc (202.8 ± 73.6 vs. 275.8 ± 60.4, p < 0.001) than PR. The diameter stenosis was least severe in OCT-erosion, followed by OCT-CN and PR (55.4 ± 14.7{\%} vs. 66.1 ± 13.5{\%} vs. 68.8 ± 12.9{\%}, p < 0.001). Conclusions Optical coherence tomography is a promising modality for identifying OCT-erosion and OCT-CN in vivo. The OCT-erosion is a frequent finding in patients with ACS, especially in those with non-ST-segment elevation ACS and younger patients. The OCT-CN is the least common etiology for ACS and is more common in older patients. (The Massachusetts General Hospital Optical Coherence Tomography Registry; NCT01110538).",
author = "Haibo Jia and Farhad Abtahian and Aguirre, {Aaron D.} and Stephen Lee and Stanley Chia and Harry Lowe and Koji Kato and Taishi Yonetsu and Rocco Vergallo and Sining Hu and Jinwei Tian and Hang Lee and Park, {Seung Jung} and Yangsoo Jang and Raffel, {Owen C.} and Kyoichi Mizuno and Shiro Uemura and Tomonori Itoh and Tsunekazu Kakuta and Choi, {So Yeon} and Dauerman, {Harold L.} and Abhiram Prasad and Catalin Toma and Iris McNulty and Shaosong Zhang and Bo Yu and Valentine Fuster and Jagat Narula and Renu Virmani and Jang, {Ik Kyung}",
year = "2013",
month = "11",
day = "5",
doi = "10.1016/j.jacc.2013.05.071",
language = "English",
volume = "62",
pages = "1748--1758",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "19",

}

Jia, H, Abtahian, F, Aguirre, AD, Lee, S, Chia, S, Lowe, H, Kato, K, Yonetsu, T, Vergallo, R, Hu, S, Tian, J, Lee, H, Park, SJ, Jang, Y, Raffel, OC, Mizuno, K, Uemura, S, Itoh, T, Kakuta, T, Choi, SY, Dauerman, HL, Prasad, A, Toma, C, McNulty, I, Zhang, S, Yu, B, Fuster, V, Narula, J, Virmani, R & Jang, IK 2013, 'In vivo diagnosis of plaque erosion and calcified nodule in patients with acute coronary syndrome by intravascular optical coherence tomography', Journal of the American College of Cardiology, vol. 62, no. 19, pp. 1748-1758. https://doi.org/10.1016/j.jacc.2013.05.071

In vivo diagnosis of plaque erosion and calcified nodule in patients with acute coronary syndrome by intravascular optical coherence tomography. / Jia, Haibo; Abtahian, Farhad; Aguirre, Aaron D.; Lee, Stephen; Chia, Stanley; Lowe, Harry; Kato, Koji; Yonetsu, Taishi; Vergallo, Rocco; Hu, Sining; Tian, Jinwei; Lee, Hang; Park, Seung Jung; Jang, Yangsoo; Raffel, Owen C.; Mizuno, Kyoichi; Uemura, Shiro; Itoh, Tomonori; Kakuta, Tsunekazu; Choi, So Yeon; Dauerman, Harold L.; Prasad, Abhiram; Toma, Catalin; McNulty, Iris; Zhang, Shaosong; Yu, Bo; Fuster, Valentine; Narula, Jagat; Virmani, Renu; Jang, Ik Kyung.

In: Journal of the American College of Cardiology, Vol. 62, No. 19, 05.11.2013, p. 1748-1758.

Research output: Contribution to journalArticle

TY - JOUR

T1 - In vivo diagnosis of plaque erosion and calcified nodule in patients with acute coronary syndrome by intravascular optical coherence tomography

AU - Jia, Haibo

AU - Abtahian, Farhad

AU - Aguirre, Aaron D.

AU - Lee, Stephen

AU - Chia, Stanley

AU - Lowe, Harry

AU - Kato, Koji

AU - Yonetsu, Taishi

AU - Vergallo, Rocco

AU - Hu, Sining

AU - Tian, Jinwei

AU - Lee, Hang

AU - Park, Seung Jung

AU - Jang, Yangsoo

AU - Raffel, Owen C.

AU - Mizuno, Kyoichi

AU - Uemura, Shiro

AU - Itoh, Tomonori

AU - Kakuta, Tsunekazu

AU - Choi, So Yeon

AU - Dauerman, Harold L.

AU - Prasad, Abhiram

AU - Toma, Catalin

AU - McNulty, Iris

AU - Zhang, Shaosong

AU - Yu, Bo

AU - Fuster, Valentine

AU - Narula, Jagat

AU - Virmani, Renu

AU - Jang, Ik Kyung

PY - 2013/11/5

Y1 - 2013/11/5

N2 - Objectives The aim of this study was to characterize the morphological features of plaque erosion and calcified nodule in patients with acute coronary syndrome (ACS) by optical coherence tomography (OCT). Background Plaque erosion and calcified nodule have not been systematically investigated in vivo. Methods A total of 126 patients with ACS who had undergone pre-intervention OCT imaging were included. The culprit lesions were classified as plaque rupture (PR), erosion (OCT-erosion), calcified nodule (OCT-CN), or with a new set of diagnostic criteria for OCT. Results The incidences of PR, OCT-erosion, and OCT-CN were 43.7%, 31.0%, and 7.9%, respectively. Patients with OCT-erosion were the youngest, compared with those with PR and OCT-CN (53.8 ± 13.1 years vs. 60.6 ± 11.5 years, 65.1 ± 5.0 years, p = 0.005). Compared with patients with PR, presentation with non-ST-segment elevation ACS was more common in patients with OCT-erosion (61.5% vs. 29.1%, p = 0.008) and OCT-CN (100% vs. 29.1%, p < 0.001). The OCT-erosion had a lower frequency of lipid plaque (43.6% vs. 100%, p < 0.001), thicker fibrous cap (169.3 ± 99.1 μm vs. 60.4 ± 16.6 μm, p < 0.001), and smaller lipid arc (202.8 ± 73.6 vs. 275.8 ± 60.4, p < 0.001) than PR. The diameter stenosis was least severe in OCT-erosion, followed by OCT-CN and PR (55.4 ± 14.7% vs. 66.1 ± 13.5% vs. 68.8 ± 12.9%, p < 0.001). Conclusions Optical coherence tomography is a promising modality for identifying OCT-erosion and OCT-CN in vivo. The OCT-erosion is a frequent finding in patients with ACS, especially in those with non-ST-segment elevation ACS and younger patients. The OCT-CN is the least common etiology for ACS and is more common in older patients. (The Massachusetts General Hospital Optical Coherence Tomography Registry; NCT01110538).

AB - Objectives The aim of this study was to characterize the morphological features of plaque erosion and calcified nodule in patients with acute coronary syndrome (ACS) by optical coherence tomography (OCT). Background Plaque erosion and calcified nodule have not been systematically investigated in vivo. Methods A total of 126 patients with ACS who had undergone pre-intervention OCT imaging were included. The culprit lesions were classified as plaque rupture (PR), erosion (OCT-erosion), calcified nodule (OCT-CN), or with a new set of diagnostic criteria for OCT. Results The incidences of PR, OCT-erosion, and OCT-CN were 43.7%, 31.0%, and 7.9%, respectively. Patients with OCT-erosion were the youngest, compared with those with PR and OCT-CN (53.8 ± 13.1 years vs. 60.6 ± 11.5 years, 65.1 ± 5.0 years, p = 0.005). Compared with patients with PR, presentation with non-ST-segment elevation ACS was more common in patients with OCT-erosion (61.5% vs. 29.1%, p = 0.008) and OCT-CN (100% vs. 29.1%, p < 0.001). The OCT-erosion had a lower frequency of lipid plaque (43.6% vs. 100%, p < 0.001), thicker fibrous cap (169.3 ± 99.1 μm vs. 60.4 ± 16.6 μm, p < 0.001), and smaller lipid arc (202.8 ± 73.6 vs. 275.8 ± 60.4, p < 0.001) than PR. The diameter stenosis was least severe in OCT-erosion, followed by OCT-CN and PR (55.4 ± 14.7% vs. 66.1 ± 13.5% vs. 68.8 ± 12.9%, p < 0.001). Conclusions Optical coherence tomography is a promising modality for identifying OCT-erosion and OCT-CN in vivo. The OCT-erosion is a frequent finding in patients with ACS, especially in those with non-ST-segment elevation ACS and younger patients. The OCT-CN is the least common etiology for ACS and is more common in older patients. (The Massachusetts General Hospital Optical Coherence Tomography Registry; NCT01110538).

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DO - 10.1016/j.jacc.2013.05.071

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EP - 1758

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

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