Prevalence and Characteristics of TCFA and Degree of Coronary Artery Stenosis An OCT, IVUS, and Angiographic Study
Prevalence and Characteristics of TCFA and Degree of Coronary Artery Stenosis An OCT, IVUS, and Angiographic Study
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DOI：
10.1016/j.jacc.2014.05.052
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发表时间：
2014-08-19
影响因子：
24
通讯作者：
Jang, Ik-Kyung
中科院分区：
文献类型：
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作者：
Tian, Jinwei;Dauerman, Harold;Jang, Ik-Kyung
背景易损斑块的特征与血管造影冠状动脉狭窄之间的关系尚不清楚。结论本研究的目的是系统地研究不同狭窄程度的薄帽纤维粥样硬化（TCFA）的绝对数量、相对患病率和特征，方法：我们从255名接受OCT成像的受试者中识别出643个斑块，所有3支冠状动脉。根据血管造影直径狭窄将其分为3组：A组（30%-49%，n = 325），B组（50%至69%，n = 227），C组结果OCT显示，A组（n = 58）TCFA绝对值最大，其次为B组（n = 40）和C组（n = 33）。然而，C组TCFA的相对患病率（36%）高于A组（18%）或B组（18%）（分别为p = 0.003和p = 0.002）。C组TCFA的纤维帽薄于A组（p < 0.001）或B组（p = 0.001）。血管内超声显示，与B组（67.5 +/- 9.4%）和A组（58.1 +/- 8.4%）相比，C组的TCFA斑块负荷最大（80.1 +/- 7.4%）。C组TCFA的重构指数高于A组（p = 0.002）。结论：非重度狭窄组TCFA的绝对数量是重度狭窄组的3倍。然而，在重度狭窄的病例中，病变为TCFA的可能性是非重度狭窄的两倍。动脉狭窄区的TCFA更具有斑块易损性特征。(C)2014年由美国心脏病学会基金会。
BACKGROUND The relationship between features of vulnerable plaque and angiographic coronary stenosis is unknown.OBJECTIVES The purpose of this study was to systematically investigate the absolute number, relative prevalence, and characteristics of thin-cap fibroatheroma (TCFA) at different degrees of stenosis using optical coherence tomography (OCT), intravascular ultrasound, and coronary angiography.METHODS We identified 643 plaques from 255 subjects who underwent OCT imaging in all 3 coronary arteries. They were divided into 3 groups on the basis of angiographic diameter stenosis: Group A (30% to 49%, n = 325), Group B (50% to 69%, n = 227), and Group C (>70%, n = 91).RESULTS OCT showed that the absolute number of TCFA was greatest in Group A (n = 58), followed by Groups B (n = 40) and C (n = 33). However, the relative prevalence of TCFA was higher in Group C (36%) than in Groups A (18%) or B (18%) (p = 0.003 and p = 0.002, respectively). Fibrous cap of TCFA was thinner in Group C than in Groups A (p < 0.001) or B (p = 0.001). intravascular ultrasound showed that the plaque burden of TCFA was largest in Group C (80.1 +/- 7.4%), compared with Groups B (67.5 +/- 9.4%) and A (58.1 +/- 8.4%). TCFA in Group C had a higher remodeling index than those in Group A (p = 0.002).CONCLUSIONS The absolute number of TCFA is 3 times greater in nonsevere stenosis than in severe stenosis. It is, however, twice as likely for a lesion to be TCFA in cases of severe stenosis than in nonsevere stenosis. Moreover, TCFA in severely-stenotic areas had more features of plaque vulnerability. (C) 2014 by the American College of Cardiology Foundation.