Evaluation of the changes in fibrous cap thickness in nonculprit coronary artery plaques using serial OCT imaging and serum biomarkers.
Presenter
Emily Janak, MD, Loyola University Medical Center, Maywood, IL
Emily Janak, MD1, Tomas Kovarnik, M.D.2, Michael Wesolowski1, Zhi Chen, PhD3, Milan Sonka, PhD3, Andreas Wahle, PhD3, Nicholas Kassis, M.D.4, Samuel Robertson1 and John J. Lopez, M.D., FSCAI5, (1)Loyola University Medical Center, Maywood, IL, (2)Charles University, Prague, Czech Republic, (3)University of Iowa, Iowa City, IA, (4)Cleveland Clinic Foundation, Cleveland, OH, (5)Loyola University Chicago, Maywood, IL
Keywords: Coronary, Imaging & Physiology and Stable Ischemic Heart Disease (SIHD)
Background
Preventing acute coronary syndromes caused by coronary artery plaque rupture remains an elusive goal of current research. There is currently limited experience using optical coherence tomography (OCT), a high-resolution imaging technique, to characterize temporal changes in fibrous cap thickness (FCT) that may result in unstable high-risk plaque precursors to plaque ruptures.
Methods
34 patients underwent nonculprit vessel OCT imaging at baseline and at 12-16 month follow-up to assess changes in mean and minimal FCT. OCT findings were analyzed by expert reader analysis. Multiple linear regression models were used to estimate the effects of demographics, biomarkers, and other predictors on average FCT at follow-up, after adjusting for average FCT at baseline.
Results
Of the 34 patients, the majority had hypertension (91%), hyperlipidemia (91%), with 64% former smokers. The median analyzed segment length was 36mm (28-42), and the median total cholesterol at baseline was 157mg/dL (141 – 184). Both the median average minimal FCT and median average FCT was slightly thinner at follow up (Median (IQR): 90um (80 – 120) and 200um (180 – 260)) than at baseline (Median (IQR): 100um (70 – 130) and 210um (180 – 270)). Results shown in table below.
Conclusions
Over a 12-16 month period in CAD patients treated with statins, FCT decreased slightly. After adjusting for average FCT at baseline, while no individual biomarker or morphologic OCT parameter was associated with a thinner average FCT at follow-up, a history of hypertension (p < 0.01) and hyperlipidemia (p = 0.03) were associated with fibrous cap thinning.
