Atherosclerotic plaque morphology indicates clinical symptoms of plaque progression

This study aimed to evaluate the relationship between plaque morphology and the plaque progression (PP) that occurs despite routine medical therapy and better risk-factor control.

A total of 183 patients who received baseline and follow-up coronary angiography were divided into 2 groups, the PP group (n = 78) and the non-PP group (n = 105). Optical coherence tomography (OCT) was performed after baseline coronary angiography. The plaque characteristics were noted and the fibrous cap thickness was measured at the thinnest point of each plaque. Macrophages in the fibrous cap were detected, and the macrophage content was measured based on the signal attenuation.

The level of high-sensitivity C-reactive protein was higher in the PP group (p = 0.001). The OCT examination showed that the proportion of lipid-rich plaques in the PP group was higher than that in the non-PP group (p < 0.001). Calcified plaques were detected frequently in the non-PP group (p < 0.001). Macrophages in the fibrous cap were detected frequently in the PP group (p < 0.001), and the macrophage content was significantly greater than that in the non-PP group (p < 0.001).

Lipid-rich plaques with large numbers of macrophages were prone to PP, whereas the progression of calcified plaques was rare.