title: The Difference between the optical coherence tomography (OCT) findings of newly progressed coronary lesions in symptomatic and asymptomatic patients.
abstract: BACKGROUND
  Generally, newly progressed coronary lesions (NPCLs) are considered to be composed of lipid-rich plaques. In case of vulnerable plaque rupture, they may quickly become culprit lesions responsible for acute coronary syndromes.
  
  
  METHODS
  Between September 2011 and September 2015, 2034 patients underwent scheduled follow-up coronary angiography (CAG) after percutaneous coronary intervention (PCI) in Tsuchiya General Hospital. Patients with NPCLs found by CAG during the follow-up period were evaluated by optical coherence tomography (OCT). NPCLs were defined as the lesions with less than 50% diameter stenosis, which progressed to more than 75% diameter stenosis within 3years after the previous CAG. Patients with restenosis after PCI were excluded. We compared OCT findings of NPCLs between symptomatic and asymptomatic patients.
  
  
  RESULTS
  The follow-up CAG showed NPCLs in 64 patients (3.2%). OCT revealed fibrous plaque in 42 patients (65.6%) and thin-cap fibroatheroma in one patient. Thirteen patients had chest symptoms for one month before CAG and the remaining 51 patients were asymptomatic. The prevalence of fibrous plaque and intimal disruption or plaque rupture were not significantly different between symptomatic and asymptomatic patients (61.5% vs. 66.7%, p=0.752 and 30.8% vs. 11.8%, p=0.213, respectively). However, thrombi were more frequently observed in symptomatic patients (61.5% vs. 13.7%, p<0.001).
  
  
  CONCLUSIONS
  The majority of NPCLs found in asymptomatic patients at follow-up CAG were not vulnerable; however, those found in symptomatic patients might be vulnerable. In clinical practice, NPCLs found in asymptomatic patients should be evaluated for functional severity of stenosis in order to determine the need for coronary revascularization.
authors: Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Moto-machi, Naka-ku, Hiroshima 730-8518, Japan. Electronic address: nobucode.0317@kfd.biglobe.ne.jp.
authors: Nobuo
authors: N
authors: Shiode
authors: Division of Cardiology, Cardiovascular Center, Akane Foundation Tsuchiya General Hospital, 3-30 Nakajima-cho, Naka-ku, Hiroshima 730-8655, Japan.
authors: Tomokazu
authors: T
authors: Okimoto
authors: Division of Cardiology, Cardiovascular Center, Akane Foundation Tsuchiya General Hospital, 3-30 Nakajima-cho, Naka-ku, Hiroshima 730-8655, Japan.
authors: Hiromichi
authors: H
authors: Tamekiyo
authors: Division of Cardiology, Cardiovascular Center, Akane Foundation Tsuchiya General Hospital, 3-30 Nakajima-cho, Naka-ku, Hiroshima 730-8655, Japan.
authors: Tomoharu
authors: T
authors: Kawase
authors: Division of Cardiology, Cardiovascular Center, Akane Foundation Tsuchiya General Hospital, 3-30 Nakajima-cho, Naka-ku, Hiroshima 730-8655, Japan.
authors: Kenichi
authors: K
authors: Yamane
authors: Division of Cardiology, Cardiovascular Center, Akane Foundation Tsuchiya General Hospital, 3-30 Nakajima-cho, Naka-ku, Hiroshima 730-8655, Japan.
authors: Yuzo
authors: Y
authors: Kagawa
authors: Division of Cardiology, Cardiovascular Center, Akane Foundation Tsuchiya General Hospital, 3-30 Nakajima-cho, Naka-ku, Hiroshima 730-8655, Japan.
authors: Yuto
authors: Y
authors: Fujii
authors: Division of Cardiology, Cardiovascular Center, Akane Foundation Tsuchiya General Hospital, 3-30 Nakajima-cho, Naka-ku, Hiroshima 730-8655, Japan.
authors: Yusuke
authors: Y
authors: Ueda
authors: Division of Cardiology, Cardiovascular Center, Akane Foundation Tsuchiya General Hospital, 3-30 Nakajima-cho, Naka-ku, Hiroshima 730-8655, Japan.
authors: Naoya
authors: N
authors: Hironobe
authors: Division of Cardiology, Cardiovascular Center, Akane Foundation Tsuchiya General Hospital, 3-30 Nakajima-cho, Naka-ku, Hiroshima 730-8655, Japan.
authors: Yasuko
authors: Y
authors: Kato
authors: Division of Cardiology, Cardiovascular Center, Akane Foundation Tsuchiya General Hospital, 3-30 Nakajima-cho, Naka-ku, Hiroshima 730-8655, Japan.
authors: Yasuhiko
authors: Y
authors: Hayashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058070:Asymptomatic Diseases / Q000453:epidemiology; D017023:Coronary Angiography / Q000379:methods* / Q000592:standards; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D041623:Tomography, Optical Coherence / Q000379:methods* / Q000592:standards
keywords: OCT; Vulnerable plaque