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Please use this identifier to cite or link to this item: http://hdl.handle.net/10564/4101

Title: Clinical Course of Optical Coherence Tomography-Detected Lipid-Rich Coronary Plaque After Optimal Medical Therapy
Other Titles: OCT で検出された冠動脈のlipid-richプラークに対する至適薬物療法施行後の臨床経過
Authors: Sugiura, Junichi
Soeda, Tsunenari
Kyodo, Atsushi
Nakamura, Takuya
Okamura, Akihiko
Nogi, Kazutaka
Hashimoto, Yukihiro
Ueda, Tomoya
Watanabe, Makoto
Saito, Yoshihiko
Keywords: Coronary computed tomography
High-risk plaque feature
Lipid rich coronary plaque
Optical coherence tomography
Optimal medical therapy
Issue Date: 3-Dec-2021
Publisher: Japanese Circulation Society
Citation: Circulation reports Vol.4 No.1 p.29-37 (2021 Dec)
Abstract: Background: The aim of this study was to evaluate optical coherence tomography (OCT)-detected lipid-rich coronary plaques (LRCPs) with coronary computed tomography angiography (CCTA) 10 months after optimal medical therapy (OMT). Methods and Results: Baseline OCT detected 28 LRCPs in non-culprit lesions. High-risk plaque features (HRPFs), such as positive remodeling, very low attenuation plaques, napkin-ring sign, and spotty calcification, were observed in 67.9%, 67.9%, 21.4%, and 64.3% of LRCPs, respectively, at the 10-month follow-up CCTA. Lesions with ≥3 HRPFs were defined as high-risk LRCPs (n=12); the remaining were defined as low-risk LRCPs (n=16). The maximum lipid arc on baseline OCT was larger in high- than low-risk LRCPs (221±62° vs. 179±44°, respectively; P=0.04). Receiver operating characteristic curve analysis indicated that a maximum lipid arc >154° on baseline OCT was the optimal cut-off value to predict high-risk LRCPs 10 months after OMT. Patients with high-risk LRCPs had worse clinical outcomes, defined as a composite of cardiac death, target lesion-related myocardial infarction, and target lesion-related revascularization, during follow-up than those with low-risk LRCPs (33.3% vs. 0%; P=0.01). Conclusions: A high-risk LRCP at follow-up CCTA was correlated with a larger maximum lipid arc on baseline OCT. Further aggressive treatment for patients with large LRCPs may reduce vulnerable plaque features and prevent future cardiac events.
Description: 博士(医学)・甲第869号・令和5年3月15日
© 2022, THE JAPANESE CIRCULATION SOCIETY This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.
URI: http://hdl.handle.net/10564/4101
ISSN: 24340790
DOI: https://doi.org/10.1253/circrep.CR-21-0147
Academic Degrees and number: 24601甲第869号
Degree-granting date: 2023-03-15
Degree name: 博士(医学)
Degree-granting institutions: 奈良県立医科大学
Appears in Collections:2022年度

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