Author + information
- 1Department of Cardiology, the Second Affiliate Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Heilongjiang Province, Chinaed Hospital of Harbin Medical University, Harbin, China
- 2Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, Harbin, China
Serial studies have demonstrated that thin-cap fibroatheroma (TCFA) lesions with a large plaque burden (≥70%) carry higher risk than small TCFA lesions, especially on the short-term follow-up. It remains unclear whether the lesion progress and vascular remodeling in TCFA with a plaque burden of ≥70% is different compared to TCFA with a plaque burden of <70%. This study aims to investigate the influence of baseline plaque burden≥70% on TCFA progression, vascular remodeling and subsequent recurrent events by optical coherence tomography(OCT) and intravascular ultrasound(IVUS).
Fifty-six thin-cap fibroatheroma (TCFA) from 47 patients with coronary artery disease were analyzed with OCT and IVUS at baseline. Serial IVUS (0 and 12 months) examinations of plaque characteristic to assess the impact of baseline plaque burden on TCFA progression and serial vascular remodeling.
There were 35 TCFAs with baseline plaque burden<70 % (group A) and 21 TCFAs with baseline plaque burden ≥70% (group B). IVUS data shows that there were significant difference between plaque burden <70% and ≥70% in mean lumen area (baseline P=0.002, follow-up P=0.003), mean plaque area (baseline P<0.0001, follow-up P=0.001) and plaque atheroma volume (baseline P<0.0001, follow-up P=0.01). Plaque burden<70% group shows negative remodeling in baseline and ≥70% was positive remodeling (group A=0.95±0.14, group B=1.04±0.15, P=0.039). There was no difference in follow-up remodeling index when comparing lesions with plaque burden <70% and ≥70% (group A=0.95±0.12, group B=0.93±0.32, P=0.68). Between plaque burden <70% and ≥70%, there were no significant in magnitude or the direction (increase or decrease) of the annual changes in plaque atheroma volume. There was no correlation between changes in plaque and EEM area (group A: r=0.32, P<0.05, group B: r=0.61, P<0.05). There were 5 major cardiovascular events in Group A, no major cardiovascular events in Group B.
TCFA progression was not associated with baseline plaque burden. However, TCFA with a plaque burden of ≥70% tend to negative remodeling. Negative remodeling in TCFA with large plaque burden may be a primarily responsible for coronary artery lumen loss and the occurrence of clinical events.