Tissue Characteristics of Residual Lesion in Patients with Acute Coronary Syndrome Caused by Plaque Rupture Versus Plaque Erosion: a Single-center, Retrospective, Observational Study

Overview

Journal Nagoya J Med Sci

Specialty General Medicine

Date 2024 Jul 4

PMID 38962413

Authors

Wataru Suzuki

Hirofumi Ohashi

Hirohiko Ando

Yusuke Nakano

Hiroaki Takashima

Masanobu Fujimoto

Hiroaki Sawada

Reiji Goto

Akihiro Suzuki

Shinichiro Sakurai

Tetsuya Amano

Affiliations

Soon will be listed here.

Abstract

Patients with acute coronary syndrome (ACS), frequently caused by plaque rupture (PR), often have vulnerable plaques in residual lesions as well as in culprit lesions. However, whether this occurs in patients with plaque erosion (PE) as well is unknown. We retrospectively analyzed the data of 88 patients with ACS who underwent both optimal coherence tomography (OCT) and intravascular ultrasound (IVUS). Based on plaque morphology of the culprit lesions identified using OCT, patients were classified into PE (n=23) and PR (n=35) groups. The tissue characteristics of residual lesions evaluated using integrated backscatter IVUS were compared between both groups after percutaneous coronary intervention. The PE group had a significantly lower percent lipid volume and a higher percent fibrous volume than the PR group (35.0±17.8% vs 49.2±13.4%, p<0.001; 63.2±17.1% vs 50.3±13.1%, p=0.002, respectively). Receiver operating characteristic curve analysis revealed that percent lipid volume in the residual lesions was a significant discriminant factor in estimating the plaque morphology of the culprit lesion (optimal cut-off value, <43.5%; sensitivity and specificity values were 73.9% and 68.6%, respectively). In conclusion, patients with PE had a significantly lower percent lipid volume and a significantly higher percent fibrous volume in the residual lesions than those with PR, suggesting that the nature of coronary plaques in patients with PE is different from that of those with PR.

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