Thin-Cap Fibroatheroma as High-Risk Plaque for Microvascular Obstruction in Patients With Acute Coronary Syndrome

• DOI: 10.1161/circimaging.111.965616
• Publication Date: 2011-09-24T08:43:36Z
• Authors: Yuichi Ozaki; Atsushi Tanaka; Takashi Tanimoto; Hironori Kitabata; Manabu Kashiwagi; Takashi Kubo; Shigeho Takarada; Kohei Ishibashi; Kenichi Komukai; Yasushi Ino; Kumiko Hirata; Masato Mizukoshi; Toshio Imanishi; Takashi Akasaka
• Keywords: Fibrous cap; Culprit; Vulnerable plaque

Background— Plaque contents can cause microvascular impairment, which is an important determinant of clinical outcomes in patients with acute coronary syndrome (ACS). We hypothesized that percutaneous intervention (PCI) for thin-cap fibroatheroma (TCFA) could easily disrupt the fibrous cap and expose plaque to flow, possibly resulting obstruction (MVO). The purpose this study was investigate whether TCFA associated MVO after PCI ACS. Methods Results— enrolled 115 ACS who were successfully recanalized PCI. divided into a ruptured group (n=59), nonrupture (n=21), non-TCFA (n=35), according optical coherence tomography findings culprit lesion. Using contrast-enhanced MRI, we assessed MVO. There no statistically significant differences patient characteristics. more frequently presented (ruptured plaque, 27%; versus TCFA, 43%; nonrupture, 9%; P =0.012). prevalence increases as thickness decreases. Conclusions— high-risk