Abstract 11270: Metabolic Factors Associated With Optical Coherence Tomography Derived Measure of Plaque Neovascularization
Background: Neovascularization within atheromatous plaques have been considered as a morphological feature of vulnerable plaque. While metabolic abnormalities cause atherosclerotic cardiovascular disease, it remains to be elucidated whether metabolic factors associated with plaque neovascularization.
Methods: We analyzed 111 patients with stable coronary artery disease who underwent frequency domain optical coherence tomography (FD-OCT) imaging within the target vessel during PCI. Plaque neovascularization was defined as signal-poor void in multiple contiguous frames. Multivariate analysis was conducted to identify metabolic factors contributing to plaque neovascularization.
Results: Neovascularization was observed in 29% of the study population, with 12.5% of patients demonstrating multiple areas of neovascularization. Patients with neovascularization were more likely to be younger (59 v. 63 years, p<0.01), smoker (70 v. 54%, p=0.04) and obese (BMI: 30.9 v. 29.0 kg/m2, p<0.01) with higher HbA1c level (7.2 v. 6.2%, p<0.05) and leukocyte counts (9519 v. 8392/ul, p<0.05). They were less likely to receive beta-blocker (60 v. 78%, p=0.01) and statin therapy (48 v. 65%, p=0.02). FD-OCT demonstrated that patients with neovascularization harbored thinner fibrous caps (86.1±43.7 v. 104.8±58.2 um, p=0.01), and were more likely to have a thin-cap fibroatheroma (64.7 v. 46.5%, p=0.01), large lipid core (lipid quadrant: 3.0 v. 2.3%, p<0.01), spotty calcium (44.1 v. 30.0%, p=0.03) and cholesterol crystal (43.2 v. 20.1%, p=0.003). Multivariate analysis demonstrated that HbA1c, BMI and statin use were associated with the development of plaque neovascularization (Table).
Conclusions: Metabolic factors associated with FD-OCT measure of plaque neovascularization in patients with stable coronary artery disease. Therapies modifying these factors may have benefits to prevent plaque neovascularization.
- © 2013 by American Heart Association, Inc.