title: Comparison of morphologic findings obtained by optical coherence tomography in acute coronary syndrome caused by vasospasm and chronic stable variant angina.
abstract: This study used optical coherence tomography (OCT) to evaluate morphologic changes in vasospastic lesions, which can cause acute coronary syndrome (ACS) or chronic stable VA. Thirty-nine patients (52.4 ± 9.0 years, 33 males) with vasospasm-induced ACS who presented with chest pain and displayed transient ST segment elevation on electrocardiography were included in the ACS group. Forty-one patients (49.3 ± 7.7 years, 33 males) who presented with chronic stable variant angina were included in the VA group. The clinical characteristics and morphologic OCT results of the two groups were compared. There were no differences in baseline characteristics, including the proportions of hypertension, diabetes mellitus, and smoking, between the two groups. Intimal tear, erosion, and intra-luminal thrombi were more frequent in the ACS group than the VA group (P < 0.001, P < 0.001, and P = 0.006, respectively). High-sensitivity C-reactive protein level was higher in the ACS group than the VA group (1.33 ± 1.93 vs 0.48 ± 0.50 mg/l, P = 0.011). Maximal intima thickness of spastic segment (0.38 ± 0.06 vs 0.31 ± 0.05 mm, P < 0.001) was significantly greater in the ACS group than in the VA group. In patients with vasospasm-induced ACS, intimal tear, intimal erosion, and microthrombi are major abnormal morphologic findings of OCT compared with patients with chronic stable VA.
authors.affiliation: Department of Internal Medicine, College of Medicine, Hanyang University Gu-ri Hospital, Gu-Ri City, Republic of Korea, pigpooh76@hanmail.net.
authors.forename: Hwan-Cheol
authors.initials: HC
authors.lastname: Park
authors.forename: Jeong Hun
authors.initials: JH
authors.lastname: Shin
authors.forename: Woo Kyoung
authors.initials: WK
authors.lastname: Jeong
authors.forename: Sung Il
authors.initials: SI
authors.lastname: Choi
authors.forename: Soon-Gil
authors.initials: SG
authors.lastname: Kim
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D000328:Adult; D060050:Angina, Stable / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000175:diagnosis / Q000209:etiology; D003329:Coronary Vasospasm / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D003331:Coronary Vessels / Q000473:pathology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D012422:Rupture, Spontaneous; D041623:Tomography, Optical Coherence