title: Thrombus and Plaque Erosion Characterized by Optical Coherence Tomography in Patients With Vasospastic Angina.
abstract: OBJECTIVE
  Vasospastic angina (VSA) can result in endothelial damage and thrombus formation. The aim of this study was to evaluate the incidence of thrombus and plaque characteristics at coronary spasm segments compared with nonspasm segments by using optical coherence tomography (OCT) in patients with suspected VSA.
  
  
  METHODS
  One hundred and eighty-three patients with suspected VSA were enrolled in this study. The ergonovine provocation test was performed in all patients for the diagnosis of VSA except in patients with spontaneous spasm. All target lesions were analyzed by OCT. Plaque erosion was defined as the presence of attached thrombus overlying an intact fibrous cap and visualized plaque on multiple adjacent OCT frames.
  
  
  RESULTS
  One hundred and nine spasm segments (93 patients) were compared with 55 nonspasm segments (39 patients). Thrombus was more frequently seen at spasm segments than at nonspasm segments (28.4% vs 7.3%; P = .026) and thrombus size was larger at spasm segments than at nonspasm segments (0.26 ± 0.50 mm2vs 0.04 ± 0.01 mm2; P = .023). Thin-cap fibroatheroma was more frequently seen at nonspasm segments than at spasm segments (16.4% vs 1.8%; P = .006). Plaque erosion was more prevalent at spasm segments than at nonspasm segments (25.7% vs 5.4%; P = .001).
  
  
  CONCLUSIONS
  Thrombus and plaque erosion were more common at spasm segments than at nonspasm segments assessed by OCT in patients with suspected VSA. These findings suggest the potential benefit and treatment role of antiplatelet therapy in vasospastic angina.
authors.affiliation: Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. Electronic address: sesim1989@gmail.com.
authors.forename: Eun-Seok
authors.initials: ES
authors.lastname: Shin
authors.affiliation: Department of Cardiology, Kangwon National University School of Medicine, Chuncheon, Korea.
authors.forename: Ae-Young
authors.initials: AY
authors.lastname: Her
authors.affiliation: Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
authors.forename: Soe Hee
authors.initials: SH
authors.lastname: Ann
authors.affiliation: Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
authors.forename: Gillian
authors.initials: G
authors.lastname: Balbir Singh
authors.affiliation: Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
authors.forename: Heeyoun
authors.initials: H
authors.lastname: Cho
authors.affiliation: Department of Mechanical and Biomedical Engineering, Kangwon National University, Chuncheon, Kangwon-do, Korea.
authors.forename: Eui Cheol
authors.initials: EC
authors.lastname: Jung
authors.affiliation: Department of Mechanical and Biomedical Engineering, Kangwon National University, Chuncheon, Kangwon-do, Korea.
authors.forename: Eun Bo
authors.initials: EB
authors.lastname: Shim
authors.affiliation: Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea.
authors.forename: Bon-Kwon
authors.initials: BK
authors.lastname: Koo
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Kimiidera, Wakayama, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Akasaka
mesh_terms: D000787:Angina Pectoris / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000150:complications* / Q000175:diagnosis; D003329:Coronary Vasospasm / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000150:complications* / Q000175:diagnosis; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D013927:Thrombosis / Q000150:complications* / Q000175:diagnosis; D041623:Tomography, Optical Coherence / Q000379:methods*
keywords: Angina vasospástica; Coronary artery spasm; Erosión de placa; Espasmo de la arteria coronaria; Optical coherence tomography; Plaque erosion; Thrombus; Tomografía de coherencia óptica; Trombo; Vasospastic angina