Abstract 11768: Role of Endothelial Shear Stress and Endothelial Shear Stress Gradient in Plaques Associated With Acute Erosion vs. Stable Control Plaques and Relationship Between Plaque Slope and Localization of Plaque Erosion

• DOI: 10.1161/circ.144.suppl_1.11768
• Publication Date: 2022-03-19T23:58:21Z
• Authors: Diaa Hakim; Ahmet U Coskun; Charles Maynard; zhongyue pu; Deborah Rupert; Nicholas Cefalo; Tej Sheth; Natalia Pinilla-E...; Kajander A Olli; Gerasimos Siasos; Michail I Papafaklis; Stefanu Kostas; Lampros K Michalis; Kevin Croce; Peter H Stone
• Keywords: 03 medical and health sciences; 0302 clinical medicine

Introduction: The role of endothelial shear stress (ESS) in the development coronary plaque erosion is unknown. High ESS gradient (ESSG) has been hypothesized to promote erosion, but no studies have included matched control stable plaques with same minimal and reference lumen area (MLA, RLA, respectively). No examined location (proximal vs distal MLA culprit plaque) related max magnitude upslope downslope obstruction. Aims: (1) compare ESSG between similar that remained stable; (2) among plaques, study effect slope steepness (Δ area/frame) up- down-stream from on thrombus location. Methods: We studied 46 patients TOTAL COMPLETE trials who underwent angiography OCT imaging: arteries: 27 LAD, 6 LCX, 13 RCA. Plaques were divided into Plaque Erosion (n=24) features before PCI (17 definite, 7 probable erosion) separate (n=22) without disruption. Orthogonal angiographic views used generate a 3-D arterial reconstruction, angio centerline was combined centerline. Local distribution assessed by computational fluid dynamics reported consecutive 3-mm segments. Among erosions, we calculated down-slope obstruction for each plaque. Results: See Table Conclusion: In similarly severe obstruction, associated higher remain stable. Proximal erosion/thrombus steeper downslope, upslope. Absolute erosions. These may help prognosticate individual at risk future erosion.