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In Vivo Diagnosis of Plaque Erosion and Calcified Nodule in Patients With Acute Coronary Syndrome by Intravascular Optical Coherence Tomography

Open access
Jia, Haibo, Abtahian, Farhad, Aguirre, Aaron D., Lee, Stephen, Chia, Stanley, Lowe, Harry, Kato, Koji, Yonetsu, Taishi, Vergallo, Rocco, Hu, Sining, Tian, Jinwei, Lee, Hang, Park, Seung-Jung, Jang, Yang-Soo, Raffel, Owen C., Mizuno, Kyoichi, Uemura, Shiro, Itoh, Tomonori, Kakuta, Tsunekazu, Choi, So-Yeon, Dauerman, Harold L., Prasad, Abhiram, Toma, Catalin, McNulty, Iris, Zhang, Shaosong, Yu, Bo, Fuster, Valentine, Narula, Jagat, Virmani, Renu, Jang, Ik-Kyung·2013·Journal of the American College of Cardiology

Abstract

Objectives To characterize the morphological features of plaque erosion and calcified nodule in patients with acute coronary syndrome (ACS) by optical coherence tomography (OCT). Background Plaque erosion and calcified nodule have not been systematically investigated in vivo. Methods One hundred and twenty-six patients with ACS who had undergone pre-intervention OCT imaging were included. The culprit lesions were classified as plaque rupture (PR), erosion (OCT-erosion), calcified nodule (OCT-CN), or others using a new set of diagnostic criteria for OCT. Results The incidences of PR, OCT-erosion, and OCT-CN were 43.7%, 31.0%, and 7.9%, respectively. Patients with OCT-erosion were the youngest compared with those with PR and OCT-CN (53.8±13.1 years vs. 60.6±11.5 years, 65.1±5.0 years, p=0.005). Compared with patients with PR, presentation with non-ST-segment elevation ACS (NSTE-ACS) was more common in patients with OCT-erosion (61.5% vs. 29.1%, p=0.008) and OCT-CN (100% vs. 29.1%, p<0.001). OCT-erosion had a lower frequency of lipid plaque (43.6% vs. 100%, p<0.001), thicker fibrous cap (169.3±99.1 μm vs. 60.4±16.6 μm, p<0.001), and smaller lipid arc (202.8±73.6° vs. 275.8±60.4°, p<0.001) than PR. The diameter stenosis was least severe in OCT-erosion followed by OCT-CN and PR (55.4±14.7% vs. 66.1±13.5% vs. 68.8±12.9%, p<0.001). Conclusions OCT is a promising modality for identifying OCT-erosion and OCT-CN in vivo. OCT-erosion is a frequent finding in patients with ACS, especially in those with NSTE-ACS and younger patients. OCT-CN is the least common etiology for ACS and is more common in older patients.

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Metadata

Authors
Jia, H., Abtahian, F., Aguirre, A. D., Lee, S., Chia, S., Lowe, H., Kato, K., Yonetsu, T., Vergallo, R., Hu, S., Tian, J., Lee, H., Park, S.-J., Jang, Y.-S., Raffel, O. C., Mizuno, K., Uemura, S., Itoh, T., Kakuta, T., Choi, S.-Y., Dauerman, H. L., Prasad, A., Toma, C., McNulty, I., Zhang, S., Yu, B., Fuster, V., Narula, J., Virmani, R., & Jang, I.-K.
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2013-11
Volume
62
Issue
19
Pages
1748-1758
ISSN
0735-1097 (ISSN-L)
OpenAlex
W1985397601
Cited by
851
References
19
FWCI
46.10
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: In Vivo Diagnosis of Plaque Erosion and Calcified Nodule in Patients With Acute Coronary Syndrome by Intravascular Optical Coherence Tomography. https://app.cochat.ai/papers/10.1016/j.jacc.2013.05.071
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Jia, H., Abtahian, F., Aguirre, A. D., Lee, S., Chia, S., Lowe, H., Kato, K., Yonetsu, T., Vergallo, R., Hu, S., Tian, J., Lee, H., Park, S.-J., Jang, Y.-S., Raffel, O. C., Mizuno, K., Uemura, S., Itoh, T., Kakuta, T., . . . Jang, I.-K. (2013). In Vivo Diagnosis of Plaque Erosion and Calcified Nodule in Patients With Acute Coronary Syndrome by Intravascular Optical Coherence Tomography. Journal of the American College of Cardiology. https://doi.org/10.1016/j.jacc.2013.05.071

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