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Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
13:07

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
PubMed

Insights

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.
Abstract

Keywords:
aortic plaquecomputed tomography angiographyhigh‐risk plaqueoptical coherence tomographypan‐vascular inflammation

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