title: Prevalence and characteristics of TCFA and degree of coronary artery stenosis: an OCT, IVUS, and angiographic study.
abstract: BACKGROUND
  The relationship between features of vulnerable plaque and angiographic coronary stenosis is unknown.
  
  
  OBJECTIVE
  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.
authors.affiliation: Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Jinwei
authors.initials: J
authors.lastname: Tian
authors.affiliation: University of Vermont, Fletcher Allen Healthcare, Burlington, Vermont.
authors.forename: Harold
authors.initials: H
authors.lastname: Dauerman
authors.affiliation: University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: Catalin
authors.initials: C
authors.lastname: Toma
authors.affiliation: Emory University Hospital, Atlanta, Georgia.
authors.forename: Habib
authors.initials: H
authors.lastname: Samady
authors.affiliation: Division of Cardiology, Memorial Heart Center, Iwate Medical School, Morioka, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Itoh
authors.affiliation: Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
authors.forename: Shoichi
authors.initials: S
authors.lastname: Kuramitsu
authors.affiliation: Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
authors.forename: Takenori
authors.initials: T
authors.lastname: Domei
authors.affiliation: Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Haibo
authors.initials: H
authors.lastname: Jia
authors.affiliation: Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Rocco
authors.initials: R
authors.lastname: Vergallo
authors.affiliation: Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Tsunenari
authors.initials: T
authors.lastname: Soeda
authors.affiliation: Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Sining
authors.initials: S
authors.lastname: Hu
authors.affiliation: Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Minami
authors.affiliation: Biostatistics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Hang
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China. Electronic address: yubodr@163.com.
authors.forename: Bo
authors.initials: B
authors.lastname: Yu
authors.affiliation: Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: ijang@partners.org.
authors.forename: Ik-Kyung
authors.initials: IK
authors.lastname: Jang
mesh_terms: D002681:China / Q000453:epidemiology; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000209:etiology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D012720:Severity of Illness Index; D041623:Tomography, Optical Coherence / Q000379:methods*; D018084:Ultrasonography, Interventional / Q000379:methods*
keywords: intravascular ultrasound; optical coherence tomography; plaque vulnerability; stenosis; thin-cap fibroatheroma