IDENTIFICATION OF PLAQUE MORPHOLOGY IN ACUTE CORONARY SYNDROM BY OPTICAL COHERENCE TOMOGRAPHY

Abstract

Optical coherence tomography (OCT) is a method of intravascular imaging of coronary arteries with a superior resolution, effectively used in an acute coronary syndrome (ACS). Aim of the study was to compare characteristics of the patients with ACS caused by plaque rupture and plaque erosion using intravascular OCT. We evaluated clinical and morphological characteristics of115 ACS patients including 59 patients in the group with plaque rupture and 56 - with plaque erosion, causing occlusion.Examination was conducted using OCT device in frequency field (C7-XR OCT Intravascular Imaging System, St. Jude Medical, St. Paul, Minnesota).Patients with plaque erosion were younger than patients in plaque rupture group (52.78±10.5 years vs 57.55±9.13 years,p=0.011); lipid plaque and thin cap fibroatheroma were more frequently found in plaque rupture than in plaque erosion group (100% vs 51.8%, p<0.001; 96.6% vs 27.6%, p<0.001; respectively); lipid arc was greater and fibrous cap thickness were thinner in plaque rupture compared to plaque erosion group (p<0.001); macrophage infiltration and cholesterol crystals were more often detected in plaque rupture than in plaque erosion (p<0.001).Thus, according to OCT, plaque rupture has more frequent characteristics of vulnerable plaque compared to plaque erosion.