2003

DOI: 10.1161/01.cir.0000044384.41037.43

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Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography

Guillermo J. Tearney

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,

Hiroshi Yabushita

²

,

Stuart L. Houser

³

et al.

Abstract: Background-Macrophage

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Mark E Brezinski1

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Cited by 638 publications

(458 citation statements)

References 30 publications

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“…The present study represents the largest series so far. OCT is the only intracoronary imaging modality that is capable of visualizing features of plaque vulnerability such as macrophage accumulation and TCFA that has been validated by histology studies 24, 25. Our results demonstrated that patients with DM had a higher prevalence of lipid‐rich plaque and macrophage accumulation at the culprit plaques, indicating a higher level of culprit plaque instability, consistent with previous pathology studies 18, 19…”

Section: Discussionsupporting

confidence: 90%

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

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³

et al. 2018

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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.

“…The present study represents the largest series so far. OCT is the only intracoronary imaging modality that is capable of visualizing features of plaque vulnerability such as macrophage accumulation and TCFA that has been validated by histology studies 24, 25. Our results demonstrated that patients with DM had a higher prevalence of lipid‐rich plaque and macrophage accumulation at the culprit plaques, indicating a higher level of culprit plaque instability, consistent with previous pathology studies 18, 19…”

Section: Discussionsupporting

confidence: 90%

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

¹

,

²

,

³

et al. 2018

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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.

“…Macrophage accumulation was seen as a bright spot with high OCT backscattering attenuation. 17) Neovascularization was defined as a small vesicular or tubular structure with a diameter 200μm. 18) The presence of lipid-laden plaques or calcification inside the …”

Section: Resultsmentioning

confidence: 99%

Clinical Characteristics of In-stent Neoatherosclerosis Causing Late Stent Failure

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et al. 2016

J Jpn Coron Assoc

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Background:In-stent neoatherosclerosis (NA) is a cause of late stent failure. Late stent failure remains a challenging issue after stenting, and its causal mechanism has not been elucidated. Objectives: The aim of this study was to investigate the clinical characteristics of late stent failure with or without NA by optical coherence tomography (OCT). Methods and results: Among 179 patients who had undergone coronary stent implantation (bare metal stent and drug-eluting stent), 22 patients experienced late stent failure with and without NA identified by OCT. The presence of lipid-laden plaque or calcification inside the stent was defined as NA. The 22 patients were divided into two groups according to OCT images: 13 patients with NA (NA group) and 9 patients without NA (non-NA group). OCT analysis also showed that thrombus was more frequently observed and maximum intimal thickness was significantly larger in the NA than in the non-NA group (35.7% vs 0.0% and 1.26 mm vs 0.98 mm, p<0.05, respectively). In terms of characteristics, in-stent restenosis lesions and use of oral anticoagulants occurred at a lower frequency, and the minimal lumen diameter was significantly smaller in the NA group than in the non-NA group (7.7% vs 44.4%, 0.0% vs 66.7%, and 0.33 mm vs 0.83mm, p<0.05, respectively). Conclusion: In-stent restenosis and use of anticoagulants may be associated with the mechanism of in-stent neoatherosclerosis.

“…Optical coherence tomography has high spatial resolution (10–15 μm), allows the evaluation of variations in plaque composition at a cellular level, and distinguishes between plaque types 138. However, correct differentiation between calcium and lipid can be challenging with optical coherence tomography, and its limited tissue penetration (1–3 mm) makes the assessment of the entire plaque volume impossible.…”

Section: Intravascular Imagingmentioning

confidence: 99%

Imaging Cardiovascular Calcification

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²

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et al. 2018

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