Plaque Rupture, Compared With Plaque Erosion, Is Associated With a Higher Level of Pancoronary Inflammation

Nakajima A, Sugiyama T, Araki M, Seegers LM, Dey D, McNulty I, Lee H, Yonetsu T, Yasui Y, Teng Y, Nagamine T, Nakamura S, Achenbach S, Kakuta T, Jang IK (2022)

Publication Type: Journal article

Publication year: 2022

Journal

Journal of the American College of Cardiology : Cardiovascular imaging Elsevier

Book Volume: 15

Pages Range: 828-839

Journal Issue: 5

DOI: 10.1016/j.jcmg.2021.10.014

Abstract

Objectives: The aim of this study was to compare the level of coronary inflammation between plaque rupture and plaque erosion using pericoronary adipose tissue (PCAT) attenuation. Background: Vascular inflammation plays a key role in plaque rupture, while the role of inflammation in plaque erosion remains less well defined. PCAT attenuation determined using computed tomography has emerged as a marker specific for coronary artery inflammation. Methods: Patients with non–ST-segment elevation acute coronary syndromes who underwent preintervention coronary computed tomographic angiography and optical coherence tomographic culprit lesion imaging were enrolled. PCAT attenuation was measured around the culprit lesion and in the proximal 40 mm of all coronary arteries. Results: Among 198 patients, plaque rupture was the underlying mechanism in 107 (54.0%) and plaque erosion in 91 (46.0%). Plaque rupture had higher PCAT attenuation than plaque erosion both at the culprit plaque level (−65.8 ± 7.5 HU vs −69.5 ± 11.4 HU; P = 0.010) and at the culprit vessel level (−67.1 ± 7.1 HU vs −69.6 ± 8.2 HU; P = 0.024). The mean PCAT attenuation of all 3 coronary arteries was also significantly higher in patients with plaque rupture than in plaque erosion, indicating a higher level of inflammation (−67.9 ± 5.7 HU vs −69.9 ± 6.8 HU; P = 0.030). In multivariable analysis, plaque rupture was significantly associated with high PCAT attenuation. Conclusions: PCAT attenuation in culprit plaque, culprit vessel, and all 3 coronary arteries was higher in plaque rupture than in plaque erosion. The results suggest that pancoronary inflammation plays a more significant role in plaque rupture than in plaque erosion. (Massachusetts General Hospital and Tsuchiura Kyodo General Hospital Coronary Imaging Collaboration; NCT04523194)

Authors with CRIS profile

Stephan Achenbach Lehrstuhl für Innere Medizin II

Involved external institutions

Cedars-Sinai Medical Center US United States (USA) (US) Veterans Affairs Healthcare System Boston and Harvard Medical School US United States (USA) (US) Tsuchiura Kyodo General Hospital JP Japan (JP) Tokyo Medical and Dental University (TMDU) / 東京医科歯科大学 JP Japan (JP) New Tokyo Hospital JP Japan (JP)

How to cite

APA:

Nakajima, A., Sugiyama, T., Araki, M., Seegers, L.M., Dey, D., McNulty, I.,... Jang, I.K. (2022). Plaque Rupture, Compared With Plaque Erosion, Is Associated With a Higher Level of Pancoronary Inflammation. Journal of the American College of Cardiology : Cardiovascular imaging, 15(5), 828-839. https://dx.doi.org/10.1016/j.jcmg.2021.10.014

MLA:

Nakajima, Akihiro, et al. "Plaque Rupture, Compared With Plaque Erosion, Is Associated With a Higher Level of Pancoronary Inflammation." Journal of the American College of Cardiology : Cardiovascular imaging 15.5 (2022): 828-839.

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