TY - JOUR
T1 - Layered plaque is associated with high levels of vascular inflammation and vulnerability in patients with stable angina pectoris
AU - Niida, Takayuki
AU - Kinoshita, Daisuke
AU - Suzuki, Keishi
AU - Yuki, Haruhito
AU - Fujimoto, Daichi
AU - Dey, Damini
AU - Lee, Hang
AU - McNulty, Iris
AU - Ferencik, Maros
AU - Yonetsu, Taishi
AU - Kakuta, Tsunekazu
AU - Jang, Ik Kyung
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.
PY - 2024
Y1 - 2024
N2 - Layered plaque, a signature of previous plaque destabilization and healing, is a known predictor for rapid plaque progression; however, the mechanism of which is unknown. The aim of the current study was to compare the level of vascular inflammation and plaque vulnerability in layered plaques to investigate possible mechanisms of rapid plaque progression. This is a retrospective, observational, single-center cohort study. Patients who underwent both coronary computed tomography angiography (CTA) and optical coherence tomography (OCT) for stable angina pectoris (SAP) were selected. Plaques were defined as any tissue (noncalcified, calcified, or mixed) within or adjacent to the lumen. Perivascular inflammation was measured by pericoronary adipose tissue (PCAT) attenuation at the plaque levels on CTA. Features of plaque vulnerability were assessed by OCT. Layered plaques were defined as plaques presenting one or more layers of different optical densities and a clear demarcation from underlying components on OCT. A total of 475 plaques from 195 patients who presented with SAP were included. Layered plaques (n = 241), compared with non-layered plaques (n = 234), had a higher level of vascular inflammation (-71.47 ± 10.74 HU vs. -73.69 ± 10.91 HU, P = 0.026) as well as a higher prevalence of the OCT features of plaque vulnerability, including lipid-rich plaque (83.8% vs. 66.7%, P < 0.001), thin-cap fibroatheroma (26.1% vs. 17.5%, P = 0.026), microvessels (61.8% vs. 34.6%, P < 0.001), and cholesterol crystals (38.6% vs. 25.6%, P = 0.003). Layered plaque was associated with a higher level of vascular inflammation and a higher prevalence of plaque vulnerability, which might play an important role in rapid plaque progression. Clinical trial registration: https://classic.clinicaltrials.gov/ct2/show/NCT04523194. Graphical abstract: Level of vascular inflammation and plaque vulnerability in patients with versus without layered plaque phenotype. In patients with stable angina pectoris, layered plaques had a higher level of pericoronary adipose tissue attenuation indicating a higher level of perivascular inflammation and a higher prevalence of optical coherence tomography features of plaque vulnerability (Figure presented.)
AB - Layered plaque, a signature of previous plaque destabilization and healing, is a known predictor for rapid plaque progression; however, the mechanism of which is unknown. The aim of the current study was to compare the level of vascular inflammation and plaque vulnerability in layered plaques to investigate possible mechanisms of rapid plaque progression. This is a retrospective, observational, single-center cohort study. Patients who underwent both coronary computed tomography angiography (CTA) and optical coherence tomography (OCT) for stable angina pectoris (SAP) were selected. Plaques were defined as any tissue (noncalcified, calcified, or mixed) within or adjacent to the lumen. Perivascular inflammation was measured by pericoronary adipose tissue (PCAT) attenuation at the plaque levels on CTA. Features of plaque vulnerability were assessed by OCT. Layered plaques were defined as plaques presenting one or more layers of different optical densities and a clear demarcation from underlying components on OCT. A total of 475 plaques from 195 patients who presented with SAP were included. Layered plaques (n = 241), compared with non-layered plaques (n = 234), had a higher level of vascular inflammation (-71.47 ± 10.74 HU vs. -73.69 ± 10.91 HU, P = 0.026) as well as a higher prevalence of the OCT features of plaque vulnerability, including lipid-rich plaque (83.8% vs. 66.7%, P < 0.001), thin-cap fibroatheroma (26.1% vs. 17.5%, P = 0.026), microvessels (61.8% vs. 34.6%, P < 0.001), and cholesterol crystals (38.6% vs. 25.6%, P = 0.003). Layered plaque was associated with a higher level of vascular inflammation and a higher prevalence of plaque vulnerability, which might play an important role in rapid plaque progression. Clinical trial registration: https://classic.clinicaltrials.gov/ct2/show/NCT04523194. Graphical abstract: Level of vascular inflammation and plaque vulnerability in patients with versus without layered plaque phenotype. In patients with stable angina pectoris, layered plaques had a higher level of pericoronary adipose tissue attenuation indicating a higher level of perivascular inflammation and a higher prevalence of optical coherence tomography features of plaque vulnerability (Figure presented.)
KW - Computed tomography angiography
KW - Layered plaque
KW - Optical coherence tomography
KW - Plaque vulnerability
KW - Vascular inflammation
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U2 - 10.1007/s11239-024-02982-3
DO - 10.1007/s11239-024-02982-3
M3 - Article
AN - SCOPUS:85191076150
SN - 0929-5305
JO - Journal of Thrombosis and Thrombolysis
JF - Journal of Thrombosis and Thrombolysis
ER -