1. Qualitative and quantitative evaluation of dynamic changes in non-culprit coronary atherosclerotic lesion morphology: a longitudinal OCT study.
- Author
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Zhang BC, Karanasos A, Gnanadesigan M, van der Sijde JN, van Ditzhuijzen N, Witberg K, Ligthart J, Diletti R, van Geuns RJ, Dijkstra J, Zijlstra F, van Soest G, and Regar E
- Subjects
- Aged, Coronary Angiography, Coronary Artery Disease pathology, Coronary Vessels pathology, Databases, Factual, Disease Progression, Female, Fibrosis, Humans, Longitudinal Studies, Male, Middle Aged, Necrosis, Predictive Value of Tests, Registries, Reproducibility of Results, Retrospective Studies, Rupture, Spontaneous, Time Factors, Coronary Artery Disease diagnostic imaging, Coronary Vessels diagnostic imaging, Plaque, Atherosclerotic, Tomography, Optical Coherence
- Abstract
Aims: There is limited in vivo evidence regarding the temporal evolution of non-culprit coronary plaque morphology. We aimed to evaluate changes in non-culprit plaque morphology over time by optical coherence tomography (OCT)., Methods and Results: Seventy-two (72) patients with 257 non-culprit segments with serial OCT studies were analysed. Non-culprit 5 mm-long coronary segments from the same imaged region were matched between baseline and follow-up. OCT plaque characterisation including automated attenuation analysis was performed, and changes over a median follow-up of 6.2 months were evaluated. On segment level, lumen area decreased from baseline to follow-up, whereas fibrous cap thickness increased. Similarly, plaque attenuation indices at follow-up were significantly decreased. Minimal cap thickness per patient did not change. In 68.5% of segments, plaque morphology did not change. Favourable change was observed in 18.4% of segments and unfavourable in 12.9%. There were no robust clinical predictors of change in plaque morphology. Attenuation analysis supported the qualitative characterisation, showing significantly different attenuation between different plaque types., Conclusions: In non-culprit coronary segments of patients with coronary artery disease under standard medical therapy, segment-level but not patient-level minimum fibrous cap thickness increases over time, with observations of both favourable and unfavourable changes in individual segments.
- Published
- 2018
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