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Deprecated: Implicit conversion from float 330.4 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Catheter+Cardiovasc+Interv 2015 ; 85 (4): E108-15 Nephropedia Template TP
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Differences Determined by Optical Coherence Tomography Volumetric Analysis in Non-Culprit Lesion Morphology and Inflammation in ST-Segment Elevation Myocardial Infarction and Stable Angina Pectoris Patients #MMPMID25178981
Galon MZ; Wang Z; Bezerra HG; Lemos PA; Schnell A; Wilson DL; Rollins AM; Costa MA; Attizzani GF
Catheter Cardiovasc Interv 2015[Mar]; 85 (4): E108-15 PMID25178981show ga
Background: While the current methodology for determining fibrous cap (FC) thickness of lipid plaques is based on manual measurements of arbitrary points, which could lead to high variability and decreased accuracy, it ignores the three-dimensional (3-D) morphology of coronary artery disease. Objective: To compare, utilizing optical coherence tomography (OCT) assessments, volumetric quantification of FC, and macrophage detection using both visual assessment and automated image processing algorithms in non-culprit lesions of STEMI and stable angina pectoris (SAP) patients. Methods: Lipid plaques were selected from 67 consecutive patients (1 artery/patient). FC was manually delineated by a computer-aided method and automatically classified into three thickness categories: FC < 65 ?m (i.e., thin-cap fibroatheroma [TCFA]), 65?150 ?m, and >150 ?m. Minimum thickness, absolute categorical surface area, and fractional luminal area of FC were analyzed. Automated detection and quantification of macrophage was performed within the segmented FC. Results: A total of 5,503 cross-sections were analyzed. STEMI patients when compared with SAP patients had more absolute categorical surface area for TCFA (0.43 ± 0.45 mm2 vs. 0.15 ± 0.25 mm2; P = 0.011), thinner minimum FC thickness (31.63 ± 17.09 ?m vs. 47.27 ± 26.56 ?m, P = 0.012), greater fractional luminal area for TCFA (1.65 ± 1.56% vs. 0.74 ± 1.2%, P = 0.046), and greater macrophage index (0.0217 ± 0.0081% vs. 0.0153 ± 0.0045%, respectively, P< 0.01). Conclusion: The novel OCT-based 3-D quantification of the FC and macrophage demonstrated thinner FC thickness and larger areas of TCFA coupled with more inflammation in non-culprit sites of STEMI compared with SAP.