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Healed Plaques in Patients With Stable Angina Pectoris
Michele Russo1, Francesco Fracassi1, Osamu Kurihara1
1From the Cardiology Division (M.R., F.F., O.K., H.O.K., V.T., M.A., H.S., T. Sugiyama, E.Y., I.-K.J.), Massachusetts General Hospital, Harvard Medical School, Boston.
Arteriosclerosis, Thrombosis, and Vascular Biology
|April 17, 2020
Summary
Healed plaques are common in stable angina patients and indicate advanced atherosclerosis. Layered healed plaques show more vulnerability features and higher stenosis in both culprit and non-culprit lesions.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Atherosclerosis Research
Background:
- Healed plaques, indicative of prior plaque destabilization, are frequently observed in coronary arteries.
- Recent advancements allow for the diagnosis of healed plaques in living patients.
Purpose of the Study:
- To investigate the prevalence and characteristics of healed plaques in patients with stable angina pectoris.
- To analyze angiographic and optical coherence tomography (OCT) features of healed plaques.
Main Methods:
- Patients with stable angina pectoris undergoing OCT imaging were included.
- Healed plaques were identified by signal-rich layers of varying optical density.
- Patients were categorized based on layered or non-layered phenotypes of the culprit lesion.
Main Results:
- Over half (53.4%) of 163 patients had layered culprit plaques.
- Layered culprit plaques were associated with multivessel disease, complex angiographic lesions, and higher prevalence of lipid plaque, macrophage infiltration, calcifications, and thrombus.
- Patients with layered culprit plaques exhibited greater lipid index and percent area stenosis.
- Non-culprit plaques in patients with layered culprit lesions also showed a higher prevalence of layered patterns, lipid phenotype, lipid index, and percent area stenosis.
Conclusions:
- Healed culprit plaques are prevalent in patients with stable angina pectoris.
- Layered healed plaques are associated with more advanced atherosclerotic burden and vulnerability features.
- These findings highlight the significance of healed plaques in understanding atherosclerosis progression and risk in stable angina.
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