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Relationship between cholesterol crystals and culprit lesion characteristics in patients with stable coronary artery disease: an optical coherence tomography study

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Abstract

Aims

Some recent studies have reported the role of cholesterol crystals (ChCs) in plaque rupture in patients with coronary artery disease. We used optical coherence tomography (OCT) to investigate the characteristics of coronary plaques that were associated with derived ChCs.

Methods

We evaluated 101 subjects with stable coronary artery disease who underwent OCT. We compared the OCT findings of the culprit lesions with ChCs to those without ChCs and investigated the background characteristics.

Results

ChCs were observed in culprit lesions of 39 patients. The frequencies of spotty calcification, microchannel structure, and lipid-rich plaque were significantly higher in patients with ChCs than those without ChCs (64.1 vs. 27.4 %, p < 0.001; 69.2 vs. 38.7 %, p = 0.003; 53.8 vs. 29.0 %, p = 0.01, respectively). On the other hand, the frequencies of thrombus, disruption, and thin-cap fibroatheroma did not differ significantly between patients with and without ChCs (15.3 vs. 24.1 %, p = 0.3; 33.3 vs. 17.7 %, p = 0.07; and 33.3 vs. 24.1 %, p = 0.3, respectively). Among the possible clinical factors, multivariate analysis showed an elevated level of glycated hemoglobin as the sole significant factor associated with ChCs.

Conclusion

ChCs are frequently associated with the major findings of vulnerable plaque, and are often seen in poorly controlled diabetic patients. Thus, ChCs might be one of the features of vulnerable plaque.

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Conflict of interest

None of the authors has any conflict of interest to declare.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-0022, Japan

    Shunichi Nakamura, Shigenobu Inami, Koji Murai, Hitoshi Takano, Kuniya Asai, Masahiro Yasutake, Wataru Shimizu & Kyoichi Mizuno

  2. Cardiovascular Center, Chiba-Hokusoh Hospital, Nippon Medical School, Chiba, Japan

    Masamichi Takano

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  1. Shunichi Nakamura
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  2. Shigenobu Inami
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  4. Masamichi Takano
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  9. Kyoichi Mizuno
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Correspondence to Shigenobu Inami.

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Nakamura, S., Inami, S., Murai, K. et al. Relationship between cholesterol crystals and culprit lesion characteristics in patients with stable coronary artery disease: an optical coherence tomography study. Clin Res Cardiol 103, 1015–1021 (2014). https://doi.org/10.1007/s00392-014-0748-5

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  • DOI: https://doi.org/10.1007/s00392-014-0748-5

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