Plaques with fibrous cap thickness of < 65 um prone to rupture, OCT study reveals

CHINA: A study published in BMC Cardiovascular Disorders found that, plaques with a fibrous cap thickness of 65 to 80 μm were more likely to rupture and/or thrombose than those with a cap thickness of 80 μm or more.

Acute coronary syndrome (ACS), a key contributor to morbidity and mortality in people with coronary artery disease, is typically brought on by the rupture of coronary plaque (CAD). One of the significant developments in the fight against ACS is the early diagnosis of plaques that are prone to rupture, or susceptible plaques. Current Optical coherence tomography (OCT) based research contradicts findings from an earlier autopsy investigation.

Therefore, the authors of this study used OCT to further analyze the relationship between plaque rupture or thrombosis and 65 μm < FCT ≤ 80 μm.

OCT was used to identify FCT for this purpose on the culprit lesions in 502 consecutively recruited patients. According to FCT, patients were divided into three groups: Group A (FCT ≤ 65 m, n = 147), Group B (65 fct ≤  80 m,="" n="84),"(fct="" 80 m, n = 271). The inpatient medical record system was used to gather clinical and laboratory data. The association between FCT and plaque rupture and/or thrombosis was examined using univariable and multivariable logistic regression models. fct ≤ 80

Key findings of the study:

• Plaques with thinner FCT, particularly those with an FCT <65 m, were more likely to rupture and/or thrombose (P< 0.001).
• Compared to plaques with FCT > 80 μm, those with FCT between 65 and 80 μm had a significantly increased risk of rupture and/or thrombosis (P < 0.001).
• In multivariable analysis, FCT ≤ 65 μm and 65 < FCT ≤ 80 μm were independent predictors for plaque rupture ([FCT ≤ 65 μm vs. FCT > 80 μm]: OR = 8.082, 95% CI = 4.861 to 13.435, P < 0.001; [65 < FCT ≤ 80 μm vs. FCT > 80 μm]: OR = 2.463, 95% CI = 1.370 to 4.430, P = 0.003), thrombosis ([FCT ≤ 65 μm vs. FCT > 80 μm]: OR = 25.224, 95% CI = 13.768 to 46.212, P < 0.001; [65 < FCT ≤ 80 μm vs. FCT > 80 μm]: OR = 3.675, 95% CI = 2.065 to 6.542, P < 0.001) and plaque rupture with thrombosis ([FCT ≤ 65 μm vs. FCT > 80 μm]: OR = 22.593, 95% CI = 11.426 to 44.674, P < 0.001; [65 < FCT ≤ 80 μm vs. FCT > 80 μm]: OR = 4.143, 95% CI = 1.869 to 9.184, P < 0.001).

The investigators came to the conclusion that compared to plaques with FCT > 80 μm, those with 65 fct ≤ 80

Future prospective in vivo investigations are required to confirm whether FCT ≤ 80 μm can predict plaque rupture or clinical outcomes or act as a treatment target for CAD patients, they added.

Reference

Liu, X., He, W., Hong, X. et al. New insights into fibrous cap thickness of vulnerable plaques assessed by optical coherence tomography. BMC Cardiovasc Disord 22, 484 (2022).

https://doi.org/10.1186/s12872-022-02896-z