Abstract 12486: Optical Coherence Tomography-Based Complex Plaque Characteristics Predict the Subsequent Progression of Non-culprit Lesion in Patients with Percutaneous Coronary Intervention
Background: During long-term follow-up, the majority of cardiovascular events in patients undergoing percutaneous coronary intervention occurs in relation to the progression of nonculprit plaque (NCP) without significant luminal stenosis at baseline. However, predictive factors for the future development of plaque progression have not been elucidated. In this study, we investigate the morphological characteristics of non-stenotic NCP which developed the late plaque progression in patient with coronary artery disease (CAD) by intravascular optical coherence tomography (OCT).
Methods and Results: Fifty-three consecutive CAD patients who underwent baseline coronary angiography and OCT were enrolled (M/F=42/11, 66.2yo), and 69 NCL with mild stenosis (<50%) were followed up. In the second coronary angiography (mean 9.1 months), we evaluated whether pre-determined NCP showed a clear progression compared to the first angiogram. At the second angiography, it was revealed that 13 NCP developed the late progression (three in newly developed acute coronary syndrome, and 10 in angiographical progression), and 56 NCP did not develop progression. Baseline minimum lumen area and minimal lumen diameters were similar between NCP with or without progression (3.52±2.31 vs 3.5±1.39mm2, 1.99±0.71 vs 2.08±0.44mm, respectively). Compared to NCP without progression, OCT analysis showed that NCP with progression had significantly higher incidence of large lipid pool with thin-cap (76 vs 14%), luminal thrombus formation (31 vs 2%), intimal erosion (62 vs 9%), convex configuration of partial plaque surface (100 vs 23%), and vaso vasorum in the plaque (76 vs 13%). Logistic regression analysis showed that large lipid pool with thin-cap, convex configuration of plaque surface and vaso vasorum are the independent predictors for the late NCP progression.
Conclusions: OCT-based complex characteristics of coronary plaque, such as large lipid pool with thin-cap, convex configuration of plaque surface and vaso vasorum formation, may predict the late progression of non-stenotic coronary atherosclerotic lesion in patients with CAD.
- © 2010 by American Heart Association, Inc.