Coronary artery calcification and plaque stability： an optical coherence tomography study

Area of Science:

• Cardiovascular Imaging
• Interventional Cardiology
• Pathology

Background:

• Coronary artery calcification (CAC) is a marker of atherosclerosis, associated with stent issues and cardiac events.
• The impact of CAC on plaque stability and its morphological significance remain debated.

Purpose of the Study:

• To investigate the relationship between coronary artery calcification (CAC) and plaque vulnerability in patients with acute coronary syndrome (ACS).
• To elucidate the morphological significance of CAC in culprit and non-culprit plaques.

Main Methods:

• Retrospective analysis of 419 ACS patients undergoing optical coherence tomography (OCT).
• Classification of plaques based on calcification size and comparison of culprit and non-culprit plaque features.
• Logistic regression to identify risk factors for culprit plaque rupture and analyze calcification-rupture relationships.

Main Results:

• Calcification was present in 53.9% of culprit and 50.3% of non-culprit plaques.
• Spotty calcification was associated with higher rates of plaque rupture, macrophages, and cholesterol crystals.
• Macrocalcification was linked to increased macrophages and cholesterol crystals; calcification was smaller in ruptured plaques.
• Culprit plaques exhibited larger calcification arc and length compared to non-culprit plaques.

Conclusions:

• Spotty calcification is associated with vulnerable plaque features in culprit lesions.
• Macrocalcification did not significantly increase plaque vulnerability.
• Culprit plaques generally have larger calcifications than non-culprit plaques.