Frequency-Domain Optical Coherence Tomographic Analysis of Plaque Microstructures at Nonculprit Narrowings in Patients Receiving Potent Statin Therapy

Kataoka, Yasufumi; Puri, Rishi; Hammadah, Muhammad; Duggal, Bhanu; Uno, Kiyoko; Kapadia, Samir; Tuzcu, E. Murat; Nissen, Steven E.; Nicholls, Stephen J.

doi:10.1016/j.amjcard.2014.05.035

Cited by 39 publications

(25 citation statements)

References 24 publications

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“…The spatial configuration of different compositions may be similar to or even more important than the amount. Indeed clinical studies have shown that statin therapy induced greater fibrous cap thickness in coronary plaques [ 28 , 29 ]. Decreased fibrous volume may result in decreased total plaque volume [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Statin Therapy on Coronary Plaque Composition Using Virtual Histology Intravascular Ultrasound: A Meta-Analysis

Zheng

Huang

et al. 2015

PLoS ONE

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ObjectivePrevious studies have indicated that statin therapy may promote plaque regression. However, the impact of statin therapy on plaque composition has not been clearly elucidated. We performed a meta-analysis to investigate the effect of statin therapy on coronary plaque composition as assessed by virtual histology intravascular ultrasound (VH-IVUS).MethodsOnline databases were searched from inception to March 1, 2015. Studies providing VH-IVUS volumetric analyses of coronary plaque composition at baseline and follow-up in patients receiving statin therapy were included. Weighted mean difference (WMD) using a random-effects model was used.ResultsTen studies involving 682 patients were included. There was a substantial reduction in fibrous volume between baseline and follow-up (WMD: -2.37 mm3, 95% confidence interval (CI) -4.01 to -0.74 mm3, P=0.004), and a significant increase in dense calcium (DC) volume (WMD: 0.89 mm3, 95% CI 0.70 to 1.08 mm3, P<0.00001). No significant change was seen in fibro-fatty and necrotic core (NC) volumes. In stratified analyses, the fibrous volume was decreased significantly (WMD: -3.39 mm3, 95% CI -6.56 to -0.21 mm3, P=0.04) and the absolute DC volume (WMD: 0.99 mm3, 95% CI 0.23 to 1.76 mm3, P=0.01) was increased in the subgroup with ≥12 months follow-up, whereas no significant change was observed in the subgroup with < 12 months follow-up. Similarly, a substantial decrease in fibrous volume (WMD: -2.01 mm3, 95% CI -3.05 to -0.96 mm3, P< 0.0002) and an increase in DC volume (WMD: 0.90 mm3, 95% CI 0.70 to 1.10 mm3, P< 0.00001) were observed in the subgroup with high-intensive statin therapy, while the change in fibrous and DC volumes approached statistical significance (P=0.05 and P=0.05, respectively) in the subgroup with low-intensive statin therapy.ConclusionsStatin treatment, particularly of high-intensity and long-term duration, induced a marked modification in coronary plaque composition including a decrease in fibrous tissue and an increase in DC.

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Section: Discussionmentioning

confidence: 99%

The Effect of Statin Therapy on Coronary Plaque Composition Using Virtual Histology Intravascular Ultrasound: A Meta-Analysis

Zheng

Huang

et al. 2015

PLoS ONE

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“…In the Effect of Atorvastatin on Fibrous Cap Thickness on Coronary Atherosclerotic Plaque as Assessed by Optical Coherence Tomography study, increased fibrous cap thickness measured by OCT occurred in correlation to reductions in LDL-c, inflammatory biomarkers and OCT-defined macrophage content (figure 2). 44 In other OCT studies, patients treated with high-intensity statins had smaller lipid arcs and greater fibrous cap thickness compared with those on lower dose or no statins 45 46. Significant regression of coronary plaque lipid core content following treatment with rosuvastatin was also seen in the Reduction in Yellow Plaque by Aggressive Lipid lowering therapy (YELLOW) study using near infrared spectroscopy 47…”

Section: Use Of Imaging For Testing Drug Efficacy In Atherosclerosismentioning

confidence: 95%

Imaging as a surrogate marker of drug efficacy in cardiovascular disease

Tarkin

Dweck

Rudd

2018

Heart

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“…Therefore, accurate and reproducible automated quantification of FC thickness and inflammation are desirable as they provide a potential opportunity to further elucidate the mechanisms involved in the transition from stable to unstable coronary artery disease. In addition, the automated methodology herewith described could further clarify the role of certain drugs such as the statins in reducing FC inflammation while promoting plaque stabilization . Additional prospective studies utilizing our methodology are required to establish the clinical relevance of our findings.…”

Section: Discussionmentioning

confidence: 95%

Differences determined by optical coherence tomography volumetric analysis in non‐culprit lesion morphology and inflammation in ST‐segment elevation myocardial infarction and stable angina pectoris patients

Galon

Wang

Bezerra

et al. 2014

Cathet Cardio Intervent

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Background While the current methodology for determining fibrous cap (FC) thickness of lipid plaques is based on manual measurements of arbitrary points, which could lead to high variability and decreased accuracy, it ignores the three-dimensional (3-D) morphology of coronary artery disease. Objective To compare, utilizing optical coherence tomography (OCT) assessments, volumetric quantification of FC, and macrophage detection using both visual assessment and automated image processing algorithms in non-culprit lesions of STEMI and stable angina pectoris (SAP) patients. Methods Lipid plaques were selected from 67 consecutive patients (1 artery/patient). FC was manually delineated by a computer-aided method and automatically classified into three thickness categories: FC < 65 μm (i.e., thin-cap fibroatheroma [TCFA]), 65–150 μm, and >150 μm. Minimum thickness, absolute categorical surface area, and fractional luminal area of FC were analyzed. Automated detection and quantification of macrophage was performed within the segmented FC. Results A total of 5,503 cross-sections were analyzed. STEMI patients when compared with SAP patients had more absolute categorical surface area for TCFA (0.43 ± 0.45 mm2 vs. 0.15 ± 0.25 mm2; P = 0.011), thinner minimum FC thickness (31.63 ± 17.09 μm vs. 47.27 ± 26.56 μm, P = 0.012), greater fractional luminal area for TCFA (1.65 ± 1.56% vs. 0.74 ± 1.2%, P = 0.046), and greater macrophage index (0.0217 ± 0.0081% vs. 0.0153 ± 0.0045%, respectively, P< 0.01). Conclusion The novel OCT-based 3-D quantification of the FC and macrophage demonstrated thinner FC thickness and larger areas of TCFA coupled with more inflammation in non-culprit sites of STEMI compared with SAP.

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Frequency-Domain Optical Coherence Tomographic Analysis of Plaque Microstructures at Nonculprit Narrowings in Patients Receiving Potent Statin Therapy

Cited by 39 publications

References 24 publications

The Effect of Statin Therapy on Coronary Plaque Composition Using Virtual Histology Intravascular Ultrasound: A Meta-Analysis

The Effect of Statin Therapy on Coronary Plaque Composition Using Virtual Histology Intravascular Ultrasound: A Meta-Analysis

Imaging as a surrogate marker of drug efficacy in cardiovascular disease

Differences determined by optical coherence tomography volumetric analysis in non‐culprit lesion morphology and inflammation in ST‐segment elevation myocardial infarction and stable angina pectoris patients

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