title: In-vivo detection of the frequency and distribution of thin-cap fibroatheroma and ruptured plaques in patients with coronary artery disease: an optical coherence tomographic study.
abstract: OBJECTIVE
  The purpose of this study was to assess the prevalence and to quantify the thin-cap fibroatheroma (TCFA) and ruptured plaques in patients with coronary artery disease using optical coherence tomography (OCT).
  
  
  BACKGROUND
  TCFA lesions are the most prevalent precursors of plaque rupture, and are responsible for acute coronary syndromes (ACS). There are limited data regarding the frequency and distribution of TCFA in diseased coronary arteries.
  
  
  METHODS
  Coronary artery OCT was performed in 78 vessels in 47 patients, with stable angina (SA) or ACS. OCT plaque characteristics were derived using criteria that had been validated earlier. TCFA was defined as rich in lipid (two or more quadrants) with thin fibrous cap (<65 μm). Comparison was made between SA and unstable angina, and culprit and nonculprit vessels.
  
  
  RESULTS
  There was a higher incidence of TCFA and plaque rupture (65 vs. 24%, P=0.003, and 40 vs. 15%, P=0.04) in ACS patients. This was reflected in a higher lipid pool (2.66 vs. 2.26 quadrants, P=0.04) and minimum fibrous cap thickness (52 vs. 74 μm, P=0.001) in ACS patients. The mean numbers of TCFA (2.5) were similar in patients with SA and ACS. However, the maximal length of TCFA (2.63 vs. 5.54 mm, P=0.026) and plaque rupture sites (P=0.046) were higher in ACS vessels. No relationship was found between baseline characteristics and TCFA incidence and plaque rupture. We identified ACS (P=0.002), higher mean lipid pool (P=0.002), longer TCFA length (P=0.007) and higher number of TCFA (P=0.02) as predictors of plaque rupture sites.
  
  
  CONCLUSIONS
  In this in-vivo study, we identified a higher incidence of longer TCFAs and plaque rupture sites associated with ACS.
authors.affiliation: Department of Cardiology, Toyohashi Heart Center, Gobudori, Oyama-cho, Toyohashi, Japan. sudhirrathore@hotmail.com
authors.forename: Sudhir
authors.initials: S
authors.lastname: Rathore
authors.forename: Mitsuyasu
authors.initials: M
authors.lastname: Terashima
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Matsuo
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kinoshita
authors.forename: Masashi
authors.initials: M
authors.lastname: Kimura
authors.forename: Etsuo
authors.initials: E
authors.lastname: Tsuchikane
authors.forename: Kenya
authors.initials: K
authors.lastname: Nasu
authors.forename: Mariko
authors.initials: M
authors.lastname: Ehara
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Asakura
authors.forename: Osamu
authors.initials: O
authors.lastname: Katoh
authors.forename: Takahiko
authors.initials: T
authors.lastname: Suzuki
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D016009:Chi-Square Distribution; D023921:Coronary Stenosis / Q000150:complications / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D005355:Fibrosis; D006801:Humans; D015994:Incidence; D007564:Japan; D008055:Lipids / Q000032:analysis; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012421:Rupture; D012720:Severity of Illness Index; D041623:Tomography, Optical Coherence
chemical_list: D008055:Lipids