Consensus Standards for Acquisition, Measurement, and Reporting of Intravascular Optical Coherence Tomography Studies

Tearney, Guillermo J.; Regar, Evelyn; Akasaka, Takashi; Adriaenssens, Tom; Barlis, Peter; Bezerra, Hiram G.; Bouma, Brett E.; Bruining, Nico; Cho, Jin‐Man; Chowdhary, Saqib; Costa, Marco A.; Silva, Ranil de; Dijkstra, Jouke; Mario, Carlo Di; Dudeck, Darius; Falk, Erlin; Feldman, Marc D.; Fitzgerald, Peter J.; García, Héctor; Gonzalo, Nieves; Granada, Juan F.; Guagliumi, Giulio; Holm, Niels Ramsing; Honda, Yasuhiro; Ikeno, Fumiaki; Kawasaki, Masanori; Kochman, Janusz; Kołtowski, Łukasz; Kubo, Takashi; Kume, Teruyoshi; Kyono, Hiroyuki; Lam, Candice C.; Lamouche, Guy; Lee, David P.; Leon, Martin B.; Maehara, Akiko; Manfrini, Olivia; Mintz, Gary S.; Mizuno, Kyiouchi; Morel, Marie‐Angèle; Nadkarni, Seemantini K.; Okura, Hiroyuki; Otake, Hiromasa; Pietrasik, Arkadiusz; Prati, Francesco; Räber, Lorenz; Radu, Maria; Rieber, Johannes; Riga, Maria; Rollins, Andrew M.; Rosenberg, Mireille; Sirbu, Vasile; Serruys, Patrick W.; Shimada, Kenei; Shinke, Toshiro; Shite, Junya; Siegel, Eliot L.; Sonada, Shinjo; Suter, Melissa J.; Takarada, Shigeho; Tanaka, Atsushi; Terashima, Mitsuyasu; Thim, Troels; Uemura, Shiro; Ughi, Giovanni Jacopo; Beusekom, Heleen M.M. van; Steen, Antonius F.W. van der; Es, Gerrit-Ann van; Soest, Gijs van; Virmani, Renu; Waxman, Sergio; Weissman, Neil J.; Weisz, Giora

doi:10.1016/j.jacc.2011.09.079

Cited by 1,496 publications

(514 citation statements)

References 13 publications

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“…Cross‐sectional OCT images were analyzed at 1‐mm intervals. Mean reference area was calculated from proximal and distal references, identified as sites with the largest lumen areas proximal and distal to the stenosis within the same segment 12, 13. Minimal lumen area was defined as the smallest lumen area within the length of the plaque 14.…”

Section: Methodsmentioning

confidence: 99%

“…Percentage area stenosis was calculated as [(mean reference lumen area−minimal lumen area)/mean reference lumen area]×100 14. Lipid was defined as a signal‐poor region with a poorly defined or diffuse border, and the degree of lipid arc was measured in lipid plaques 12, 13. Fibrous cap thickness (FCT) overlying a lipid plaque was measured 3 times at its thinnest part, and the average value was calculated 7, 12.…”

Section: Methodsmentioning

confidence: 99%

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Coronary Plaque Characteristics in Patients With Diabetes Mellitus Who Presented With Acute Coronary Syndromes

Sugiyama

Yamamoto

Bryniarski

et al. 2018

JAHA

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BackgroundDiabetes mellitus (DM) is a major risk factor for cardiovascular events. We aimed to investigate the coronary plaque phenotype of diabetic patients who presented with acute coronary syndromes by optical coherence tomography.Methods and ResultsA total of 322 patients with acute coronary syndromes who underwent preintervention optical coherence tomography imaging of the culprit lesion were included. Culprit plaque characteristics were compared between patients with DM (n=95) and those without DM (n=227). In the subgroup of 250 patients in whom sufficient length of nonculprit region in the culprit vessel was imaged by optical coherence tomography, the characteristics of nonculprit plaques were also evaluated. Patients with DM had a higher prevalence of lipid‐rich plaque (58.9% versus 44.9%, P=0.030) and macrophage accumulation (60.0% versus 44.9%, P=0.019) in the culprit lesion compared with patients without DM. The prevalence of plaque rupture (33.7% versus 30.4%, P=0.896) and plaque erosion (21.1% versus 22.0%, P=0.458) was similar. In the nonculprit lesions, the DM group had greater maximal lipid arc (248.9°±83.9° versus 179.9°±58.3°, P=0.006), thinner fibrous cap thickness (103.3±56.2 μm versus 140.7±70.0 μm, P=0.013), and a higher prevalence of thin‐cap fibroatheroma (17.2% versus 6.3%, P=0.031), compared with the non‐DM group.ConclusionsCompared with patients without DM, those with DM had more vulnerable features in both culprit and nonculprit lesions, thus indicating a higher level of panvascular instability.Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT01110538.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Coronary Plaque Characteristics in Patients With Diabetes Mellitus Who Presented With Acute Coronary Syndromes

Sugiyama

Yamamoto

Bryniarski

et al. 2018

JAHA

View full text Add to dashboard Cite

show abstract

“…After the culprit lesion was identified, underlying plaque morphology was analyzed by 2 experienced reviewers using the previously reported criteria 2, 17, 18, 19. Plaques were classified as: (1) fibrous (homogeneous, high backscattering region) or (2) lipid (low‐signal region with diffuse border) 17, 20.…”

Section: Methodsmentioning

confidence: 99%

“…Plaques were classified as: (1) fibrous (homogeneous, high backscattering region) or (2) lipid (low‐signal region with diffuse border) 17, 20. In lipid plaques, fibrous cap thickness was measured 3 times at the thinnest part, and the average value was calculated.…”

Section: Methodsmentioning

confidence: 99%

“…Optical coherence tomography (OCT) has recently been introduced as a high‐resolution intravascular imaging modality that enables in vivo diagnosis of PE as well as evaluation of vascular response to stent implantation 2, 17. In the present study, we investigated the acute stent complications (dissection, malapposition, and intrastent tissue prolapsed) and 1‐year outcomes in patients with ACS caused by PR versus erosion.…”

Section: Introductionmentioning

confidence: 99%

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Management and Outcome of Patients With Acute Coronary Syndrome Caused by Plaque Rupture Versus Plaque Erosion: An Intravascular Optical Coherence Tomography Study

Zhu

Zhang

et al. 2017

JAHA

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BackgroundPlaque rupture and erosion are the 2 most common mechanisms for acute coronary syndromes. However, the outcome of these 2 distinct pathologies in patients with acute coronary syndromes has never been studied.Methods and ResultsWe retrospectively studied 141 patients with acute coronary syndromes who underwent optical coherence tomography (OCT) imaging of the culprit lesion prior to stenting from the Massachusetts General Hospital OCT Registry. Management (stent versus no stent), poststent OCT findings, and outcomes were compared. Among the 141 culprit lesions, rupture was found in 79 (56%) patients and erosion in 62 (44%). Stent implantation was performed in 77 (97.5%) patients with rupture versus 49 (79.0%) in those with erosion (P<0.001). Immediately after percutaneous coronary intervention, OCT showed a higher incidence of malapposition (37.5% versus 7.3%, P<0.001), thrombus (59.4% versus 14.6%, P<0.001), and protrusion (93.8% versus 73.2%, P=0.008) in the rupture group compared with the erosion group. Plaque rupture was associated with a higher incidence of no reflow or slow flow and distal embolization. Although cardiac event rates were comparable between the two groups at the 1‐year follow‐up, none of the erosion patients who were treated conservatively without stenting had adverse cardiac events.ConclusionsUnfavorable poststent OCT findings were more frequent in rupture patients compared with erosion patients. A subset of erosion patients who were treated conservatively without stenting remained free of adverse cardiac events for up to 1 year.

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Effect of Alirocumab Added to High-Intensity Statin Therapy on Coronary Atherosclerosis in Patients With Acute Myocardial Infarction

Räber

Ueki

Otsuka

et al. 2022

JAMA

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199

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IMPORTANCECoronary plaques that are prone to rupture and cause adverse cardiac events are characterized by large plaque burden, large lipid content, and thin fibrous caps. Statins can halt the progression of coronary atherosclerosis; however, the effect of the proprotein convertase subtilisin kexin type 9 inhibitor alirocumab added to statin therapy on plaque burden and composition remains largely unknown.OBJECTIVE To determine the effects of alirocumab on coronary atherosclerosis using serial multimodality intracoronary imaging in patients with acute myocardial infarction. DESIGN, SETTING, AND PARTICIPANTSThe PACMAN-AMI double-blind, placebo-controlled, randomized clinical trial (enrollment: May 9, 2017, through October 7, 2020; final follow-up: October 13, 2021) enrolled 300 patients undergoing percutaneous coronary intervention for acute myocardial infarction at 9 academic European hospitals.INTERVENTIONS Patients were randomized to receive biweekly subcutaneous alirocumab (150 mg; n = 148) or placebo (n = 152), initiated less than 24 hours after urgent percutaneous coronary intervention of the culprit lesion, for 52 weeks in addition to high-intensity statin therapy (rosuvastatin, 20 mg).MAIN OUTCOMES AND MEASURES Intravascular ultrasonography (IVUS), near-infrared spectroscopy, and optical coherence tomography were serially performed in the 2 non-infarct-related coronary arteries at baseline and after 52 weeks. The primary efficacy end point was the change in IVUS-derived percent atheroma volume from baseline to week 52. Two powered secondary end points were changes in near-infrared spectroscopy-derived maximum lipid core burden index within 4 mm (higher values indicating greater lipid content) and optical coherence tomography-derived minimal fibrous cap thickness (smaller values indicating thin-capped, vulnerable plaques) from baseline to week 52. RESULTS Among 300 randomized patients (mean [SD] age, 58.5 [9.7] years; 56 [18.7%] women; mean [SD] low-density lipoprotein cholesterol level, 152.4 [33.8] mg/dL), 265 (88.3%) underwent serial IVUS imaging in 537 arteries. At 52 weeks, mean change in percent atheroma volume was −2.13% with alirocumab vs −0.92% with placebo (difference, −1.21% [95% CI, −1.78% to −0.65%], P < .001). Mean change in maximum lipid core burden index within 4 mm was −79.42 with alirocumab vs −37.60 with placebo (difference, −41.24 [95% CI, −70.71 to −11.77]; P = .006). Mean change in minimal fibrous cap thickness was 62.67 μm with alirocumab vs 33.19 μm with placebo (difference, 29.65 μm [95% CI,]; P = .001). Adverse events occurred in 70.7% of patients treated with alirocumab vs 72.8% of patients receiving placebo.CONCLUSIONS AND RELEVANCE Among patients with acute myocardial infarction, the addition of subcutaneous biweekly alirocumab, compared with placebo, to high-intensity statin therapy resulted in significantly greater coronary plaque regression in non-infarct-related arteries after 52 weeks. Further research is needed to understand whether alirocumab improves clinical outcomes ...

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Consensus Standards for Acquisition, Measurement, and Reporting of Intravascular Optical Coherence Tomography Studies

Abstract: This document may be broadly used as a standard reference regarding the current state of the IVOCT imaging modality, intended for researchers and clinicians who use IVOCT and analyze IVOCT data.

Cited by 1,496 publications

References 13 publications

Coronary Plaque Characteristics in Patients With Diabetes Mellitus Who Presented With Acute Coronary Syndromes

Coronary Plaque Characteristics in Patients With Diabetes Mellitus Who Presented With Acute Coronary Syndromes

Management and Outcome of Patients With Acute Coronary Syndrome Caused by Plaque Rupture Versus Plaque Erosion: An Intravascular Optical Coherence Tomography Study

Effect of Alirocumab Added to High-Intensity Statin Therapy on Coronary Atherosclerosis in Patients With Acute Myocardial Infarction

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