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OCT-Defined Morphological Characteristics of Coronary Artery Spasm Sites in Vasospastic Angina

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Author(s)
Eun-Seok ShinSoe Hee AnnGillian Balbir SinghKyung Hun LimHyuck-Jun YoonSeung-Ho HurAe-Young HerBon-Kwon KooTakashi Akasaka ABSTRACT
Keimyung Author(s)
Yoon, Hyuck JunHur, Seung Ho
Department
Dept. of Internal Medicine (내과학)
Journal Title
JACC: Cardiovascular Imaging
Issued Date
2015
Volume
8
Issue
9
Keyword
Acute myocardial infarctionCardiac arrestIntravascular imagingPlaque erosionPlaque rupturePrinzmetal angina
Abstract
OBJECTIVES The aim of this study was to define the morphological features of coronary artery spasm sites using
optical coherence tomography (OCT) in patients with vasospastic angina (VSA).
BACKGROUND Plaque characteristics at coronary artery spasm sites have not been investigated systematically.
METHODS Sixty-nine consecutive patients (80 spasm sites) presenting with VSA who underwent OCT imaging were
included in this study. Fibrous cap disruption was identified by the discontinuation of fibrous cap with or without intraplaque
cavity formation. OCT-defined erosion was established by the presence of thrombus with or without lumen irregularity
overlying an intact fibrous cap on multiple adjacent OCT frames. Other morphological features such as the absence of
thrombus with or without lumen irregularity and those not in the previously mentioned criteria were also documented.
RESULTS Plaque was seen on OCT in 79 of the 80 spasm sites. Fibrous cap disruption was detected at 3 sites (4%).
OCT-defined erosion was observed at 21 spasm sites (26%). Thrombus with lumen irregularity was observed in 20 sites,
whereas 1 site had thrombus without lumen irregularity. Lumen irregularity without thrombus was observed at 49
spasm sites (61%). Spontaneous spasm was seen more frequently in patients with acute myocardial infarction and
out-of-hospital cardiac arrest than in patients without these conditions (50.0% vs. 19.3%, p ¼ 0.025).
CONCLUSIONS Our results show that OCT-defined erosion at spasm sites occurred in more than one-fourth of patients
in this study. Luminal irregularity was observed in nearly two-thirds of the patients without overlying thrombus. These
findings suggest the potential role of antiplatelet therapy in VSA.
Keimyung Author(s)(Kor)
윤혁준
허승호
Publisher
School of Medicine
Citation
Eun-Seok Shin et al. (2015). OCT-Defined Morphological Characteristics of Coronary Artery Spasm Sites in Vasospastic Angina. JACC: Cardiovascular Imaging, 8(9), 1059–1067. doi: 10.1016/j.jcmg.2015.03.010
Type
Article
ISSN
1936-878X
DOI
10.1016/j.jcmg.2015.03.010
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33013
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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