Abstract 17517: Impact of Coronary Calcification Morphology on Acute Coronary Syndrome Presenting as a Non-ruptured Plaque at the Culprit Site
Introduction: Previous pathological and computed tomography studies have revealed that vulnerable plaques exhibit a high frequency of spotty calcification. Some studies have also indicated that spotty calcification relates to plaque rupture at the culprit site of acute coronary syndrome (ACS). However, the morphological features of coronary calcification at the culprit site of non-ruptured plaques have not yet been elucidated. Optical frequency domain imaging (OFDI) provides tissue images of the coronary artery wall, which enable the assessment of the morphological features of coronary calcification.
Hypothesis: We hypothesized that coronary calcification at the culprit site of ACS presenting as non-ruptured plaques has different features from spotty calcification.
Methods: We enrolled 254 consecutive patients with ACS (mean age: 67 ± 11 years; 209 males). Culprit lesion morphologies were assessed by OFDI, and patients were divided into two groups according to the presence of culprit plaque rupture. To assess the morphological features of coronary calcification, we determined the maximum thickness, maximum area, maximum angle, and minimum depth from the lumen in axial sections and in longitudinal length, and then compared these data between the two groups.
Results: Non-ruptured plaques at the culprit site were detected in 122 patients. There were no significant differences in terms of age and gender between the two groups. Maximum angle was greater (142 ± 11 vs. 72 ± 13; p = 0.001), and minimum depth from the lumen was smaller (118 ± 12 μm vs. 157 ± 14 μm, p = 0.04) in the group with non-ruptured plaques. Longitudinal length tended to be greater in the group with non-ruptured plaques (5.1 ± 0.6 vs. 3.5 ± 0.7; P = 0.07).
Conclusions: Compared with ruptured plaque lesions, coronary calcification at the culprit site of ACS presenting as non-ruptured plaques exhibited a greater angle and was closer to the lumen. Coronary calcification might have some role in the pathological mechanisms of ACS presenting as non-plaque ruptures, which might be different from that of spotty calcification.
- Coronary artery calcification (CAC)
- Acute coronary syndromes
- Coronary interventions
- Interventional studies
Author Disclosures: S. Miyauchi: None. M. Kato: None. K. Dote: None. S. Sasaki: None. N. Oda: None.
- © 2016 by American Heart Association, Inc.