Dose Micro-Channel Structure Identified by Optical Coherence Tomography Demonstrate Plaque Vulnerability in Patients With Coronary Artery Disease?
Wakayama Medical University, Wakyama, Japan
H. Kitabata, A. Tanaka, T. Kubo, S. Takarada, K. Ishibashi, K. Komukai, T. Tanimoto, Y. Ino, K. Hirata, K. Takemoto, K. Kimura, M. Mizukoshi, T. Imanishi, T. Akasaka
Background: Increased neovascularization in atherosclerotic plaques is associated with plaque vulnerability. To date, however, an appropriate in vivo imaging modality that identify this feature of vulnerable plaque has been lacking. The high-resolution of OCT may provide a chance to directly visualize plaque neovascularization. The purpose of this study was to investigate the relationship between micro-channels in culprit plaques identified by optical coherence tomography (OCT) and plaque vulnerability in patients with coronary artery disease (CAD).
Methods: We enrolled 63 patients with CAD, and examined lesion morphologies by using both OCT and intravascular ultrasound before any interventions.
Results: Micro-channel was defined as a no-signal capillary-like tubular structure on the cross-sectional OCT image. Micro-channels were found in 24 (38%) of 63 patients. According to the presence or absence of micro-channel, patients were divided into two groups with or without micro-channel. The frequency of plaque rupture tended to be higher in the micro-channel group (50% vs. 28%, p=0.11). The thickness of fibrous cap (median 60¥ìm vs. 100¥ìm, p=0.001) was significantly thinner in patients with micro-channel, and there were significant differences in the frequency of thin-cap fibroatheroma (54% vs. 21%, p=0.012) and positive remodeling (67% vs. 36%, p=0.02) between the two groups. High-sensitivity C-reactive protein (hs-CRP) levels in the micro-channel group was significantly higher than those in the no micro-channel group (median 0.27mg/dl vs. 0.13mg/dl, p=0.015). Moreover, increased micro-channel counts were associated with higher hs-CRP levels (p=0.01).
Conclusion: There was a significant relationship between micro-channels in plaques identified by OCT and plaque vulnerability in patients with CAD.
