Association of coronary plaque composition and arterial remodelling: a optical coherence tomography study

Conflicting data have been reported about the association between plaque composition and remodelling index (RI). The aim of this study is to evaluate the relationship between plaque morphology obtained by optical coherence tomography (OCT) and arterial remodelling.

OCT and intravascular ultrasound imaging pull back was performed at corresponding sites on 94 lesions in 47 patients. OCT plaque characteristics for lipid content, fibrous cap thickness, thin-cap fibroatheroma (TCFA), plaque rupture, thrombus, calcification and erosion were derived using validated criteria. Compared with intermediate/negative remodelling (RI<1.0), positive remodelling (RI>1.0) was associated with presence of higher lipid pool (2.86 ± 0.42 vs. 2.20 ± 0.78; p<0.001), thin fibrous cap (47.86 ± 25.43 μm vs. 74.41 ± 32.41 μm; p<0.001), TCFA>3mm (82.1% vs. 22.7%; p<0.0001), plaque rupture and thrombus (42.8% vs. 19.7%; p = 0.024), and higher plaque burden (73.70 vs. 70.70; p = 0.048). No difference was observed in the presence of calcification and plaque erosions.

Coronary lesions with positive remodelling show higher incidences of vulnerable plaque and plaque rupture across the lesion length. This potentially explains the correlation between unstable coronary syndromes and positive remodelling.