title: Serial volumetric assessment of coronary fibroatheroma by optical frequency domain imaging: insights from the TROFI trial.
abstract: Coronary lesions precursors of acute events remain elusive, since they undergo continuous changes and their temporal changes are not very well-characterized. In natural history studies, optical frequency domain imaging (OFDI) has been used only to assess fibroatheromas as a 2D structure and sometimes in a single frame fashion. We aim at describing the serial volumetric modifications of the fibrous cap (FC) of the fibroatheromas as determined by OFDI over a 6-month follow-up period.
  
  
  
  In 49 patients, OFDI investigation was performed following treatment of culprit lesion and at 6-month follow-up in patients with ST-segment elevation myocardial infarction (STEMI). A fully automatic volumetric quantification of FC was done in all lipid-containing frames of non-culprit lesions in the infarct related artery. These lesions were matched at baseline and 6-month follow-up. A total of 58 non-culprit lipid rich lesions (34 TCFAs and 24 thick-cap fibroatheroma [ThCFA]) were found in 34 patients at baseline. Overall, there was a FC volume decrease of 1.57 (Inter-quartile Range [IQR] -4.13 to 0.54) mm3 at 6-months. 27% of the lesions changed their phenotype over time (TCFA or ThCFA). TCFAs that became ThCFAs at follow-up had smaller mean and maximal FC as compared with lesions that remained TCFAs (P = 0.01 for both).
  
  
  
  Non-culprit fibroatheromas located in the infarct related artery of patients with STEMI had a volumetric reduction of the FC after 6-month follow-up. Quantitative FC assessment was able to differentiate high-risk lesions that became ThCFAs. There was a considerable change of plaque phenotype (TCFAs or ThCFAs) over time.
authors.affiliation: Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo, Brazil.|Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
authors.forename: Carlos M
authors.initials: CM
authors.lastname: Campos
authors.affiliation: Division of Interventional Cardiology, MedStar Cardiovascular Research Network, MedStar Washington Hospital Center, Washington, DC, USA.
authors.forename: Hector M
authors.initials: HM
authors.lastname: Garcia-Garcia
authors.affiliation: Cardiovascular Science, University of Sheffield and Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.
authors.forename: Javaid
authors.initials: J
authors.lastname: Iqbal
authors.affiliation: Department of Cardiology, Fujita Health University Hospital, Toyoake, Aichi, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Muramatsu
authors.affiliation: Erasmus University Medical Centre, Thoraxcenter, Rotterdam, The Netherlands.
authors.forename: Shimpei
authors.initials: S
authors.lastname: Nakatani
authors.affiliation: Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Jouke
authors.initials: J
authors.lastname: Dijkstra
authors.affiliation: Erasmus University Medical Centre, Thoraxcenter, Rotterdam, The Netherlands.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Onuma
authors.affiliation: International Centre for Circulatory Health, NHLI, Imperial College London, London, UK.
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000601:surgery; D011446:Prospective Studies; D018570:Risk Assessment; D000072657:ST Elevation Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate; D017131:Thrombectomy / Q000379:methods*; D013997:Time Factors; D041623:Tomography, Optical Coherence / Q000379:methods*; D016896:Treatment Outcome
keywords: atherosclerosis; optical coherence tomography ; thin-cap fribroatheroma ; vulnerable plaque 