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Clinical significance of healed plaque detected by optical coherence tomography: a 2-year follow-up study

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Abstract

Recent studies have shown that healed plaque at the culprit lesion detected by optical coherence tomography (OCT) is a sign of pan-vascular vulnerability and advanced atherosclerosis. However, the clinical significance of healed plaque is unknown. A total of 265 patients who had OCT imaging of a culprit vessel and 2-year clinical follow-up data were included. Patients were stratified based on the presence or absence of a layered plaque phenotype, defined as layers of different optical density by OCT at either culprit or non-culprit lesions. The association between layered plaque and major adverse cardiac events (MACE), defined as cardiac death, acute coronary syndromes (ACS), or revascularization, was studied. Among 265 patients, 96 (36.2%) had the layered plaque phenotype. Layered plaque was more frequently observed in stable angina pectoris patients than in ACS patients (57.8%vs. 25.1%, p < 0.001). The average clinical follow-up period was 672 ± 172 days. Cumulative MACE was significantly higher in patients with layered plaque (p = 0.041), which was primarily driven by the high revascularization rate at 2 years (p = 0.002). Multivariate regression analysis showed that presence of layered plaque and low-density lipoprotein cholesterol levels were independently associated with an increased risk of revascularization (p = 0.026, p = 0.008, respectively). Patients with healed plaque in the culprit vessel had a higher incidence of revascularization, as compared to those without healed plaque, at 2 years.

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Acknowledgements

Dr. Jang’s research was supported by Mr. Michael and Mrs. Kathryn Park and by Mrs. Gill and Mr. Allan Gray. We are grateful to Greg Gheewalla and Iris A. McNulty, RN (Massachusetts General Hospital).

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Authors and Affiliations

  1. Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 800, Boston, MA, 02114, USA

    Osamu Kurihara, Michele Russo, Hyung Oh Kim, Makoto Araki, Hiroki Shinohara & Ik-Kyung Jang

  2. Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Hang Lee

  3. Cardiovascular Center, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamakari, Inzai, Chiba, 270-1694, Japan

    Masamichi Takano

  4. Mitsukoshi Health and Welfare Foundation, Tokyo, Japan

    Kyoichi Mizuno

  5. Department of Cardiology, Kyung Hee University Hospital, Seoul, Korea

    Ik-Kyung Jang

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  1. Osamu Kurihara
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  2. Michele Russo
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  3. Hyung Oh Kim
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  4. Makoto Araki
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  5. Hiroki Shinohara
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  7. Masamichi Takano
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  9. Ik-Kyung Jang
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Correspondence to Masamichi Takano or Ik-Kyung Jang.

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Conflict of interest

Dr. Jang has received educational grants from Abbott Vascular. They had no role in the design or conduct of this research. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Kurihara, O., Russo, M., Kim, H.O. et al. Clinical significance of healed plaque detected by optical coherence tomography: a 2-year follow-up study. J Thromb Thrombolysis 50, 895–902 (2020). https://doi.org/10.1007/s11239-020-02076-w

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  • DOI: https://doi.org/10.1007/s11239-020-02076-w

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