Plaque morphology assessed by optical coherence tomography in the culprit lesions of the first episode of acute myocardial infarction in patients with low low-density lipoprotein cholesterol level
•Plaque erosion is the second major pathological substrate of acute coronary syndrome (ACS).•Plaque erosion is characterized with intact fibrous cap on optical coherence tomography.•Patients with low low-density lipoprotein cholesterol showed more intact fibrous cap at the culprit lesion.•Intact fib...
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| Veröffentlicht in: | Journal of cardiology 2020-05, Vol.75 (5), p.485-493 |
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| creator | Yonetsu, Taishi Hoshino, Masahiro Lee, Tetsumin Kanaji, Yoshihisa Yamaguchi, Masao Hada, Masahiro Sumino, Yohei Ohya, Hiroaki Kanno, Yoshinori Hirano, Hidenori Horie, Tomoki Niida, Takayuki Matsuda, Junji Umemoto, Tomoyuki Sasaoka, Taro Hatano, Yu Sugiyama, Tomoyo Sasano, Tetsuo Kakuta, Tsunekazu |
| description | •Plaque erosion is the second major pathological substrate of acute coronary syndrome (ACS).•Plaque erosion is characterized with intact fibrous cap on optical coherence tomography.•Patients with low low-density lipoprotein cholesterol showed more intact fibrous cap at the culprit lesion.•Intact fibrous cap plaque might be the major cause of ACS after failed primary prevention.
There remains a residual risk for acute myocardial infarction (AMI) even with low low-density lipoprotein cholesterol (LDL-C) levels. This study aimed to characterize the culprit lesion morphology of AMI by optical coherence tomography (OCT) in patients with low LDL-C.
Four-hundred and nine culprit lesions of 409 patients with their first presentation of AMI imaged by OCT were investigated. OCT analysis included the presence of plaque rupture and thin-capped fibroatheroma (TCFA). Fibrous cap thickness and lipid length were also measured. Intravascular ultrasound (IVUS) was performed in 368 (90.0%) patients. OCT and IVUS findings were compared between patients with LDL-C |
| doi_str_mv | 10.1016/j.jjcc.2020.01.001 |
| format | Article |
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There remains a residual risk for acute myocardial infarction (AMI) even with low low-density lipoprotein cholesterol (LDL-C) levels. This study aimed to characterize the culprit lesion morphology of AMI by optical coherence tomography (OCT) in patients with low LDL-C.
Four-hundred and nine culprit lesions of 409 patients with their first presentation of AMI imaged by OCT were investigated. OCT analysis included the presence of plaque rupture and thin-capped fibroatheroma (TCFA). Fibrous cap thickness and lipid length were also measured. Intravascular ultrasound (IVUS) was performed in 368 (90.0%) patients. OCT and IVUS findings were compared between patients with LDL-C < 100 mg/dl (lower-LDL group) and those with LDL ≥ 100 mg/dl (higher-LDL group).
Lower-LDL group included 93 (22.7%) patients. Plaque rupture (54.8% vs. 68.7%, p = 0.018) and TCFA (39.8% vs. 54.6%, p = 0.013) were less frequently observed in lower-LDL than in higher-LDL. Fibrous cap was thicker [73 (59–109) µm vs. 63 (57–83) µm, p = 0.028] and lipid length was smaller [5.4 (2.3–9.9) mm vs. 7.1 (4.1–10.5) mm, p = 0.012] in lower-LDL than in higher-LDL. There were no significant differences in IVUS parameters including plaque burden or remodeling index between the two groups.
Patients with lower LDL-C showed more prevalent intact fibrous cap and less vulnerable features in the culprit lesions, which may suggest the need for exploring a specific strategy for the prevention of plaque erosion in low LDL-C subjects.</description><identifier>ISSN: 0914-5087</identifier><identifier>EISSN: 1876-4738</identifier><identifier>DOI: 10.1016/j.jjcc.2020.01.001</identifier><identifier>PMID: 32085904</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Acute myocardial infarction ; Aged ; Aged, 80 and over ; Cholesterol ; Female ; Humans ; Lipoproteins, LDL - blood ; Male ; Middle Aged ; Myocardial Infarction - blood ; Myocardial Infarction - diagnostic imaging ; Myocardial Infarction - pathology ; Optical coherence tomography ; Plaque rupture ; Plaque, Atherosclerotic - blood ; Plaque, Atherosclerotic - diagnostic imaging ; Plaque, Atherosclerotic - pathology ; Tomography, Optical Coherence ; Ultrasonography, Interventional</subject><ispartof>Journal of cardiology, 2020-05, Vol.75 (5), p.485-493</ispartof><rights>2020 Japanese College of Cardiology</rights><rights>Copyright © 2020 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c424t-288c18aa281f806a68a8538e6e94aaeb0c2a8e9eba17f4dd8bfcadf9e6e945153</citedby><cites>FETCH-LOGICAL-c424t-288c18aa281f806a68a8538e6e94aaeb0c2a8e9eba17f4dd8bfcadf9e6e945153</cites><orcidid>0000-0002-1798-5008</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jjcc.2020.01.001$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32085904$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yonetsu, Taishi</creatorcontrib><creatorcontrib>Hoshino, Masahiro</creatorcontrib><creatorcontrib>Lee, Tetsumin</creatorcontrib><creatorcontrib>Kanaji, Yoshihisa</creatorcontrib><creatorcontrib>Yamaguchi, Masao</creatorcontrib><creatorcontrib>Hada, Masahiro</creatorcontrib><creatorcontrib>Sumino, Yohei</creatorcontrib><creatorcontrib>Ohya, Hiroaki</creatorcontrib><creatorcontrib>Kanno, Yoshinori</creatorcontrib><creatorcontrib>Hirano, Hidenori</creatorcontrib><creatorcontrib>Horie, Tomoki</creatorcontrib><creatorcontrib>Niida, Takayuki</creatorcontrib><creatorcontrib>Matsuda, Junji</creatorcontrib><creatorcontrib>Umemoto, Tomoyuki</creatorcontrib><creatorcontrib>Sasaoka, Taro</creatorcontrib><creatorcontrib>Hatano, Yu</creatorcontrib><creatorcontrib>Sugiyama, Tomoyo</creatorcontrib><creatorcontrib>Sasano, Tetsuo</creatorcontrib><creatorcontrib>Kakuta, Tsunekazu</creatorcontrib><title>Plaque morphology assessed by optical coherence tomography in the culprit lesions of the first episode of acute myocardial infarction in patients with low low-density lipoprotein cholesterol level</title><title>Journal of cardiology</title><addtitle>J Cardiol</addtitle><description>•Plaque erosion is the second major pathological substrate of acute coronary syndrome (ACS).•Plaque erosion is characterized with intact fibrous cap on optical coherence tomography.•Patients with low low-density lipoprotein cholesterol showed more intact fibrous cap at the culprit lesion.•Intact fibrous cap plaque might be the major cause of ACS after failed primary prevention.
There remains a residual risk for acute myocardial infarction (AMI) even with low low-density lipoprotein cholesterol (LDL-C) levels. This study aimed to characterize the culprit lesion morphology of AMI by optical coherence tomography (OCT) in patients with low LDL-C.
Four-hundred and nine culprit lesions of 409 patients with their first presentation of AMI imaged by OCT were investigated. OCT analysis included the presence of plaque rupture and thin-capped fibroatheroma (TCFA). Fibrous cap thickness and lipid length were also measured. Intravascular ultrasound (IVUS) was performed in 368 (90.0%) patients. OCT and IVUS findings were compared between patients with LDL-C < 100 mg/dl (lower-LDL group) and those with LDL ≥ 100 mg/dl (higher-LDL group).
Lower-LDL group included 93 (22.7%) patients. Plaque rupture (54.8% vs. 68.7%, p = 0.018) and TCFA (39.8% vs. 54.6%, p = 0.013) were less frequently observed in lower-LDL than in higher-LDL. Fibrous cap was thicker [73 (59–109) µm vs. 63 (57–83) µm, p = 0.028] and lipid length was smaller [5.4 (2.3–9.9) mm vs. 7.1 (4.1–10.5) mm, p = 0.012] in lower-LDL than in higher-LDL. There were no significant differences in IVUS parameters including plaque burden or remodeling index between the two groups.
Patients with lower LDL-C showed more prevalent intact fibrous cap and less vulnerable features in the culprit lesions, which may suggest the need for exploring a specific strategy for the prevention of plaque erosion in low LDL-C subjects.</description><subject>Acute myocardial infarction</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cholesterol</subject><subject>Female</subject><subject>Humans</subject><subject>Lipoproteins, LDL - blood</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - blood</subject><subject>Myocardial Infarction - diagnostic imaging</subject><subject>Myocardial Infarction - pathology</subject><subject>Optical coherence tomography</subject><subject>Plaque rupture</subject><subject>Plaque, Atherosclerotic - blood</subject><subject>Plaque, Atherosclerotic - diagnostic imaging</subject><subject>Plaque, Atherosclerotic - pathology</subject><subject>Tomography, Optical Coherence</subject><subject>Ultrasonography, Interventional</subject><issn>0914-5087</issn><issn>1876-4738</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1TAQhS0EoreFF2CBvGSTYDt_jsQGVUCRKsEC1tbEmTSOnDjYTqu8Hw-G01tYItmyNPrmzPgcQt5wlnPG6_dTPk1a54IJljOeM8afkROXTZ2VTSGfkxNreZlVTDYX5DKEibGatbJ-SS4KwWTVsvJEfn-38GtDOju_js66u51CCJhOT7udujUaDZZqN6LHRSONbnZ3HtZxp2ahcUSqN7t6E6nFYNwSqBsey4PxIVJcTXA9HkXQW0yDdqfB9yaJmmUAr2NqOqRWiAaXGOiDiSO17uG4WY9LMHGn1qxu9S5iInVaFENE72waeo_2FXkxgA34-um9Ij8_f_pxfZPdfvvy9frjbaZLUcZMSKm5BBCSD5LVUEuQVSGxxrYEwI5pARJb7IA3Q9n3shs09EP7CFS8Kq7Iu7Nu2iSZFqKaTdBoLSzotqBEUSdjy4aJhIozqr0LweOgkkcz-F1xpo701KSO9NSRnmJcpfRS09sn_a2bsf_X8jeuBHw4A5h-eW_Qq6DNEUtvPOqoemf-p_8HcxOyog</recordid><startdate>20200501</startdate><enddate>20200501</enddate><creator>Yonetsu, Taishi</creator><creator>Hoshino, Masahiro</creator><creator>Lee, Tetsumin</creator><creator>Kanaji, Yoshihisa</creator><creator>Yamaguchi, Masao</creator><creator>Hada, Masahiro</creator><creator>Sumino, Yohei</creator><creator>Ohya, Hiroaki</creator><creator>Kanno, Yoshinori</creator><creator>Hirano, Hidenori</creator><creator>Horie, Tomoki</creator><creator>Niida, Takayuki</creator><creator>Matsuda, Junji</creator><creator>Umemoto, Tomoyuki</creator><creator>Sasaoka, Taro</creator><creator>Hatano, Yu</creator><creator>Sugiyama, Tomoyo</creator><creator>Sasano, Tetsuo</creator><creator>Kakuta, Tsunekazu</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1798-5008</orcidid></search><sort><creationdate>20200501</creationdate><title>Plaque morphology assessed by optical coherence tomography in the culprit lesions of the first episode of acute myocardial infarction in patients with low low-density lipoprotein cholesterol level</title><author>Yonetsu, Taishi ; Hoshino, Masahiro ; Lee, Tetsumin ; Kanaji, Yoshihisa ; Yamaguchi, Masao ; Hada, Masahiro ; Sumino, Yohei ; Ohya, Hiroaki ; Kanno, Yoshinori ; Hirano, Hidenori ; Horie, Tomoki ; Niida, Takayuki ; Matsuda, Junji ; Umemoto, Tomoyuki ; Sasaoka, Taro ; Hatano, Yu ; Sugiyama, Tomoyo ; Sasano, Tetsuo ; Kakuta, Tsunekazu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c424t-288c18aa281f806a68a8538e6e94aaeb0c2a8e9eba17f4dd8bfcadf9e6e945153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Acute myocardial infarction</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cholesterol</topic><topic>Female</topic><topic>Humans</topic><topic>Lipoproteins, LDL - blood</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - blood</topic><topic>Myocardial Infarction - diagnostic imaging</topic><topic>Myocardial Infarction - pathology</topic><topic>Optical coherence tomography</topic><topic>Plaque rupture</topic><topic>Plaque, Atherosclerotic - blood</topic><topic>Plaque, Atherosclerotic - diagnostic imaging</topic><topic>Plaque, Atherosclerotic - pathology</topic><topic>Tomography, Optical Coherence</topic><topic>Ultrasonography, Interventional</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yonetsu, Taishi</creatorcontrib><creatorcontrib>Hoshino, Masahiro</creatorcontrib><creatorcontrib>Lee, Tetsumin</creatorcontrib><creatorcontrib>Kanaji, Yoshihisa</creatorcontrib><creatorcontrib>Yamaguchi, Masao</creatorcontrib><creatorcontrib>Hada, Masahiro</creatorcontrib><creatorcontrib>Sumino, Yohei</creatorcontrib><creatorcontrib>Ohya, Hiroaki</creatorcontrib><creatorcontrib>Kanno, Yoshinori</creatorcontrib><creatorcontrib>Hirano, Hidenori</creatorcontrib><creatorcontrib>Horie, Tomoki</creatorcontrib><creatorcontrib>Niida, Takayuki</creatorcontrib><creatorcontrib>Matsuda, Junji</creatorcontrib><creatorcontrib>Umemoto, Tomoyuki</creatorcontrib><creatorcontrib>Sasaoka, Taro</creatorcontrib><creatorcontrib>Hatano, Yu</creatorcontrib><creatorcontrib>Sugiyama, Tomoyo</creatorcontrib><creatorcontrib>Sasano, Tetsuo</creatorcontrib><creatorcontrib>Kakuta, Tsunekazu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yonetsu, Taishi</au><au>Hoshino, Masahiro</au><au>Lee, Tetsumin</au><au>Kanaji, Yoshihisa</au><au>Yamaguchi, Masao</au><au>Hada, Masahiro</au><au>Sumino, Yohei</au><au>Ohya, Hiroaki</au><au>Kanno, Yoshinori</au><au>Hirano, Hidenori</au><au>Horie, Tomoki</au><au>Niida, Takayuki</au><au>Matsuda, Junji</au><au>Umemoto, Tomoyuki</au><au>Sasaoka, Taro</au><au>Hatano, Yu</au><au>Sugiyama, Tomoyo</au><au>Sasano, Tetsuo</au><au>Kakuta, Tsunekazu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Plaque morphology assessed by optical coherence tomography in the culprit lesions of the first episode of acute myocardial infarction in patients with low low-density lipoprotein cholesterol level</atitle><jtitle>Journal of cardiology</jtitle><addtitle>J Cardiol</addtitle><date>2020-05-01</date><risdate>2020</risdate><volume>75</volume><issue>5</issue><spage>485</spage><epage>493</epage><pages>485-493</pages><issn>0914-5087</issn><eissn>1876-4738</eissn><abstract>•Plaque erosion is the second major pathological substrate of acute coronary syndrome (ACS).•Plaque erosion is characterized with intact fibrous cap on optical coherence tomography.•Patients with low low-density lipoprotein cholesterol showed more intact fibrous cap at the culprit lesion.•Intact fibrous cap plaque might be the major cause of ACS after failed primary prevention.
There remains a residual risk for acute myocardial infarction (AMI) even with low low-density lipoprotein cholesterol (LDL-C) levels. This study aimed to characterize the culprit lesion morphology of AMI by optical coherence tomography (OCT) in patients with low LDL-C.
Four-hundred and nine culprit lesions of 409 patients with their first presentation of AMI imaged by OCT were investigated. OCT analysis included the presence of plaque rupture and thin-capped fibroatheroma (TCFA). Fibrous cap thickness and lipid length were also measured. Intravascular ultrasound (IVUS) was performed in 368 (90.0%) patients. OCT and IVUS findings were compared between patients with LDL-C < 100 mg/dl (lower-LDL group) and those with LDL ≥ 100 mg/dl (higher-LDL group).
Lower-LDL group included 93 (22.7%) patients. Plaque rupture (54.8% vs. 68.7%, p = 0.018) and TCFA (39.8% vs. 54.6%, p = 0.013) were less frequently observed in lower-LDL than in higher-LDL. Fibrous cap was thicker [73 (59–109) µm vs. 63 (57–83) µm, p = 0.028] and lipid length was smaller [5.4 (2.3–9.9) mm vs. 7.1 (4.1–10.5) mm, p = 0.012] in lower-LDL than in higher-LDL. There were no significant differences in IVUS parameters including plaque burden or remodeling index between the two groups.
Patients with lower LDL-C showed more prevalent intact fibrous cap and less vulnerable features in the culprit lesions, which may suggest the need for exploring a specific strategy for the prevention of plaque erosion in low LDL-C subjects.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>32085904</pmid><doi>10.1016/j.jjcc.2020.01.001</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-1798-5008</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Acute myocardial infarction Aged Aged, 80 and over Cholesterol Female Humans Lipoproteins, LDL - blood Male Middle Aged Myocardial Infarction - blood Myocardial Infarction - diagnostic imaging Myocardial Infarction - pathology Optical coherence tomography Plaque rupture Plaque, Atherosclerotic - blood Plaque, Atherosclerotic - diagnostic imaging Plaque, Atherosclerotic - pathology Tomography, Optical Coherence Ultrasonography, Interventional |
| title | Plaque morphology assessed by optical coherence tomography in the culprit lesions of the first episode of acute myocardial infarction in patients with low low-density lipoprotein cholesterol level |
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