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Updated: Jun 17, 2026

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

Long-term prognostic impact of optical coherence tomography detected plaque rupture in nonculprit coronary segments

Flavio Giuseppe Biccirè1, Eloisa Arbustini2, Yukio Ozaki3

  • 1Cardiovascular Sciences Department, San Giovanni Addolorata Hospital, Rome, Italy; Centro per la Lotta Contro L'Infarto, CLI Foundation, Rome, Italy.

Atherosclerosis
|June 15, 2026
PubMed

Insights

Nonculprit plaque rupture, identified by optical coherence tomography, was not an independent predictor of cardiac events. Its presence did not improve risk prediction beyond established features like thin-cap fibroatheroma.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Medical Imaging

Background:

  • Atherosclerotic plaque rupture is a primary cause of acute coronary syndrome.
  • The prognostic impact of plaque rupture in nonculprit coronary arteries is not well understood.

Purpose of the Study:

  • To investigate the long-term clinical outcomes associated with nonculprit plaque rupture detected by optical coherence tomography (OCT).
  • To determine if nonculprit plaque rupture independently predicts cardiac events.

Main Methods:

  • Prospective investigation within the CLIMA study.
  • Optical coherence tomography (OCT) used to detect nonculprit plaque rupture.
  • 5-year follow-up for major adverse cardiac events (MACE), including cardiac death and target-segment myocardial infarction (TS-MI).

Main Results:

  • Nonculprit plaque rupture was identified in 7.3% of patients.
  • Associated factors included three-vessel disease, total plaque length, thin-cap fibroatheroma (TCFA), and large lipid arc.
  • While associated with MACE in univariable analysis, it was not an independent predictor in multivariable models.
  • Nonculprit plaque rupture did not improve the predictive accuracy of TCFA for cardiac events.

Conclusions:

  • Nonculprit plaque rupture is not an independent predictor of cardiac events at 5-year follow-up.
  • Its identification does not enhance the predictive value of existing high-risk morphological features like TCFA.
  • Further research is warranted to fully elucidate the clinical relevance of nonculprit plaque rupture.
Abstract

Keywords:
AtherosclerosisClinical outcomesNonculprit plaque ruptureOptical coherence tomographyPlaque ruptureThin-cap fibroatheroma

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