Abstract 9382: Patterns of Coronary Plaque Progression: Phasic versus Linear A Combined Optical Coherence Tomography and Intravascular Ultrasound Study
Background: The traditional notion of gradual plaque growth was recently challenged by a new concept of step-wise phasic progression through plaque disruption and thrombosis cycles, or intraplaque hemorrhage. Systematic in vivo study has not been reported. The current study aimed to investigate the plaque progression patterns with serial intravascular ultrasound (IVUS) examinations, and to evaluate the relationship between plaque characteristics and plaque progression pattern, assessed by optical coherence tomography (OCT) and IVUS.
Methods and Results: Two hundred and forty eight coronary lesions from 157 patients were identified and imaged by both OCT and IVUS at baseline. IVUS examination was repeated at 6 months and 12 months. Plaque progression was defined as ≥5% increase in percent atheroma volume (PAV) by IVUS. Among 248 lesions, 190 (77%) showed no progression. Among 58 lesions with progression, 20 (34%) showed gradual linear growth, whereas 38 (66%) showed step-wise phasic progression. Multivariate analysis demonstrated that thin cap fibroatheroma (TCFA) (OR, 5.24; [95% CI, 2.04-13.4]; P=0.001), microvessel (OR, 2.20; [95% CI, 1.10-4.79]; P=0.045), and positive remodeling (OR, 2.64; [95% CI, 1.19-5.81]; P=0.016) were independently associated with phasic progression.
Conclusions: Despite contemporary medical therapy, 23% of coronary plaques show continuous progression. Among the lesions with progression, one third shows gradual linear progression and two third phasic progression. Presence of TCFA, microvessel, and positive remodeling were the independent predictors for phasic pattern of coronary plaque progression.
Author Disclosures: J. Tian: None. J. Hou: None. H. Yu: None. T. Soeda: None. R. Vergallo: None. H. Jia: None. H. Lee: None. B. Yu: None. I. Jang: None.
- © 2014 by American Heart Association, Inc.