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Coronary CT angiography characteristics of OCT-defined thin-cap fibroatheroma: a section-to-section comparison study

  • Cardiac
  • Published:
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Abstract

Objectives

To evaluate whether plaque characteristics as assessed by coronary computed tomography angiography (CCTA) were associated with the presence of a thin-cap fibroatheroma (TCFA)—a precursor of plaque rupture—defined by optical coherence tomography (OCT) in a section-to-section-level comparison.

Methods

From 28 symptomatic patients, 31 coronary lesions were evaluated on 727 cross-sections co-registered by both CCTA and OCT. CCTA plaque characteristics included low attenuation plaque (LAP, <30 HU), napkin ring sign (NRS), positive remodelling (PR, remodelling index ≥1.10), and spotty calcification and plaque area and plaque burden. By OCT, presence of TCFA, lumen area and arc of lipid were determined.

Results

OCT revealed a TCFA in 69 (9.4%) sections from 19 (61.2 %) lesions. In per-section analysis, OCT-TCFA showed higher frequency of CCTA-detected LAP (58.0% vs. 18.5%), NRS (31.9% vs. 8.8%) and PR (68.1% vs. 48.0%) and greater plaque burden (70.6% vs. 61.9%) as compared to sections without OCT-TCFA (all p < 0.05). In multivariable analysis, LAP (odds ratio [OR] 4.05, p < 0.001) and NRS (OR 2.47, p = 0.005) were associated with OCT-TCFA. CCTA-measured lumen area correlated well with OCT-measured lumen area (R = 0.859, limits of agreement −0.5 ± 3.7 mm2).

Conclusions

LAP and NRS in CCTA were associated with the presence of OCT-defined TCFA in a section-to-section comparison.

Key Points

• CT-defined LAP and NRS were associated with OCT-defined TCFA

• OCT-TCFA showed higher frequency of LAP, NRS, PR and greater plaque burden

• Non-calcified plaque area was correlated with OCT-measured lipid arc

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Author notes

  1. Dong Hyun Yang and Soo-Jin Kang equally contributed to this work.

Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Dong Hyun Yang, Hyun Jung Koo, Joon-Won Kang & Tae-Hwan Lim

  2. Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Soo-Jin Kang, Mineok Chang, Pil Hyung Lee, Jae-Hyung Roh, Jung-Min Ahn, Duk-Woo Park, Seung-Whan Lee, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park & Young-Hak Kim

  3. Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Seunghee Baek

  4. Department of Applied Statistics, Gachon University, Gyeonggi-do, Korea

    Seungbong Han

  5. Cardiovascular Research Foundation, New York, NY, USA

    Gary S. Mintz

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  1. Dong Hyun Yang
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Corresponding author

Correspondence to Young-Hak Kim.

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Guarantor

The scientific guarantor of this publication is Young-Hak Kim.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Funding

This research was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (NRF-2016R1A1A1A05921207 and NRF-2015R1A2A2A04003034) and a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry for Health & Welfare, Republic of Korea (HI14C0517, HI15C1790 and HI17C1080).

Statistics and biometry

Statistical analysis was performed and reviewed by two experts of medical statistics who were included in the author list of this manuscript (S.B., S.H.)

Informed consent

Written informed consent was waived by the institutional review board.

Ethical approval

Institutional review board approval was obtained.

Methodology

• Retrospective

• Diagnostic study

• Performed at one institution

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Yang, D.H., Kang, SJ., Koo, H.J. et al. Coronary CT angiography characteristics of OCT-defined thin-cap fibroatheroma: a section-to-section comparison study. Eur Radiol 28, 833–843 (2018). https://doi.org/10.1007/s00330-017-4992-8

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  • DOI: https://doi.org/10.1007/s00330-017-4992-8

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