Abstract 12856: High Prevalence of Healed Ruptured Plaques Detected by Optical Coherence Tomography in Coronary High-Intensity Plaques on Non-Contrast T1-Weighted Magnetic Resonance Imaging
Background: We have shown that coronary high-intensity plaques (HIPs) on non-contrast T1-weighted imaging (T1WI) represent plaque vulnerability. However, it remains unclear whether HIPs are associated with vulnerable plaque features detected by optical coherence tomography (OCT) such as thin-cap fibroatheroma (TCFA), plaque rupture, or intra-coronary thrombus. Recently, healed ruptured plaques, comprised of a layered pattern underlying poor signaled region with diffuse border, is a novel feature for predicting plaque vulnerability.
Method: Twenty-one patients with stable coronary artery disease (CAD) underwent non-contrast T1WI within 2 days prior to elective percutaneous coronary intervention (PCI) with OCT study to calculate the plaque-to-myocardium signal intensity ratio (PMR). CAD patients were categorized as HIP positive if any lesion identified plaque had a PMR>1.4.
Results: Of the 22 lesions studied, 11 (50%) lesions were positive for HIP and 11 (50%) were negative for HIP (non-HIP). Figure shows a representative case having left anterior descending artery lesion (A, arrow) that was positive for HIP with 2.27 of PMR (B) and was characterized as healed ruptured plaque by OCT (C). There were no significant differences in age, male gender, and history of diabetes mellitus, hypertension, dyslipidemia, and current smoking. On OCT analysis, in the HIP group, the prevalence of healed rupture plaque was significantly higher (HIP, 82% vs. non-HIP, 27%, p=0.03) and the degree of lipid-arc was greater than non-HIP group (HIP, 201.0 ± 26.7° vs non-HIP, 171.5 ± 35.3°, p=0.034). However, no significant differences were observed in the prevalence of TCFA, lipid-rich plaque, ruptured plaque, thrombus, and calcification between the 2 groups (Table).
Conclusions: The present OCT analysis showed that prevalence of healed ruptured plaque and degree of lipid-arc were high in plaques with HIPs, which are therefore associated with plaque vulnerability.
Author Disclosures: T. Kanaya: None. T. Noguchi: None. H. Asaumi: None. R. Fujiwara: None. M. Fujino: None. T. Yamane: None. T. Nagai: None. S. Kawakami: None. S. Honda: None. M. Ishihara: None. Y. Gotoh: None. H. Ogawa: None. S. Yasuda: None.
- © 2014 by American Heart Association, Inc.