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Degree of luminal narrowing and composition of thrombus in plaque erosion

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Abstract

As the degree of luminal narrowing increases, shear stress increases, and high shear stress is known to activate platelets. However, the relationship between the degree of luminal narrowing and the composition of thrombus in patients with plaque erosion has not been studied. A total of 148 patients with plaque erosion and thrombus detected by optical coherence tomography were divided into tertiles based on the minimum lumen area (MLA) at the culprit lesion. Thrombus was categorized as platelet-rich or fibrin-rich. Among 148 patients, 50 (34%) were in the mild stenosis group, 49 (33%) were in the moderate stenosis group, and 49 (33%) were in the severe stenosis group. The composition of thrombus was significantly different among the 3 groups (prevalence of platelet-rich thrombus was 60% in the mild stenosis group; 78% in the moderate stenosis group; and 84% in the severe stenosis group; P = 0.021). The pattern of fibrin-rich thrombus showed the opposite: 40%, 22%, and 16%, respectively. In the multivariate analysis, current smoking was independently associated with fibrin-rich thrombus (odds ratio [OR] 2.364 [95% CI 1.004–5.567], P = 0.049). This study demonstrated that platelet-rich thrombus was the predominant type of thrombus in plaque erosion. The prevalence of fibrin-rich thrombus was highest in the mild stenosis group.

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Acknowledgements

Dr. Jang’s research was supported by Mr. and Mrs. Allan and Gill Gray and by Mr. and Mrs. Michael and Kathryn Park.

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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, Francesco Fracassi, Makoto Araki, Akihiro Nakajima, Iris McNulty & Ik-Kyung Jang

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

    Masamichi Takano

  3. Department of Cardiovascular Medicine, Nara Medical University, Nara, Japan

    Tsunenari Soeda

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

    Hang Lee

  5. Mitsukoshi Health and Welfare Foundation, Tokyo, Japan

    Kyoichi Mizuno

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

    Ik-Kyung Jang

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  1. Osamu Kurihara
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  2. Masamichi Takano
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Correspondence to Masamichi Takano or Ik-Kyung Jang.

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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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Kurihara, O., Takano, M., Soeda, T. et al. Degree of luminal narrowing and composition of thrombus in plaque erosion. J Thromb Thrombolysis 51, 143–150 (2021). https://doi.org/10.1007/s11239-020-02159-8

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