Abstract 17585: Optical Coherence Tomography Findings of Macrophage Accumulation in Atherothrombotic Plaques
Backgrounds: Macrophage plays an important role in triggering plaque rupture and in the development of acute coronary syndrome (ACS). Optical coherence tomography (OCT) is a high resolution (about 10μm), intravascular imaging modality, capble of investigating detailed coronary plaque morphology. This study aimed to investigate the clinical significance of OCT for detecting macrophage accumulation in patients.
Methods and Results: Ex-Vivo Study. OCT images of 30 atherothrombotic debris captured by filter based distal protection device (Filtrap, NIPRO, Japan) (Figure B) were compared with histology. Macrophage density was quantified by immunohistochemical staining with CD14 (proinflammatory surface marker of macrophage), and compared with the maximal normalized standard deviation of the OCT signal intensity (NSD) in each debris (Figure A). There were significant positive correlation between CD14-positive macrophage density and NSD (R=0.523, P=0.04).
In-Vivo Study: OCT were performed to detect macrophage accumulation (MPA), characterized by high intensity signal with increased NSD within fibrous cap (Figure C), in patients with ACS and stable angina pectoris (SAP). MPA was detected in 23 of 24 ACS patients and in 22 of 42 SAP patients (P<0.01, sensitivity: 0.96, specificity: 0.52). ROC analysis indicated NSD cutoff value of 0.173 between ACS and SAP (sensitivity 1.0, specificity 0.67).
Conclusions: OCT can be used to estimate macrophage contents within atherothrombotic plaque and, therefore, to detect vulnerable plaque in patients.
- © 2010 by American Heart Association, Inc.