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Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
Published on: January 15, 2022
Protruding Aortic Plaque and Coronary Plaque Vulnerability.
Haruhito Yuki1, Eric Isselbacher1, Takayuki Niida1
1Cardiology Division, Massachusetts General Hospital, Harvard Medical School Boston MA USA.
Journal of the American Heart Association
|January 9, 2024
Summary
Protruding aortic plaque is linked to more vulnerable coronary plaques and a higher risk of cardiac and cerebrovascular events. This finding highlights the importance of assessing aortic plaque for predicting patient outcomes.
Area of Science:
- Cardiovascular Medicine
- Radiology
- Interventional Cardiology
Background:
- Protruding aortic plaque is a known risk factor for cardiovascular and cerebrovascular events.
- The association between protruding aortic plaque and coronary plaque characteristics remains under-investigated.
Purpose of the Study:
- To investigate the relationship between protruding aortic plaque and coronary plaque vulnerability.
- To assess coronary plaque characteristics in patients with and without protruding aortic plaque.
Main Methods:
- Computed tomography angiography (CTA) and preintervention optical coherence tomography (OCT) imaging were performed on 615 patients.
- Coronary plaque characteristics, including thin-cap fibroatheroma, lipid-rich plaque, macrophages, layered plaque, and plaque rupture, were analyzed.
- Patient cohorts were compared based on the presence or absence of protruding aortic plaque.
Main Results:
- Patients with protruding aortic plaque (n=186) were older and had more comorbidities.
- A significantly higher prevalence of vulnerable coronary plaque features was observed in patients with protruding aortic plaque (e.g., thin-cap fibroatheroma: 45.7% vs 28.0%, P<0.001; plaque rupture: 51.6% vs 25.9%, P<0.001).
- Patients with protruding aortic plaque experienced a greater incidence of major adverse cardiac and cerebrovascular events (e.g., all-cause mortality, acute coronary syndromes, stroke).
Conclusions:
- Protruding aortic plaque is associated with increased coronary plaque vulnerability.
- Patients with protruding aortic plaque face a higher risk of future adverse cardiovascular and cerebrovascular events.
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