<abstract xmlns="http://www.w3.org/1999/xhtml">The <bold>aim</bold> of this systematic review was to analyze studies characterizing vulnerable coronary plaques using optical coherence tomography (OCT) and intravascular ultrasound (IVUS), in order to identify the most efficient invasive technique permitting plaque characterization in patients with acute myocardial infarction.<bold>Method:</bold> A total number of 432 studies were identified, 420 through database searching and 12 through manual searching. Eight duplicate studies were removed, leaving a total number of 424 studies to be screened. Twenty-six studies only available in Abstract-only form were excluded, resulting in 398 studies checked for eligibility. Eleven studies fulfilled the eligibility criteria and were included in this systematic analysis. Plaque vulnerability was investigated in plaques with thin cap fibroatheroma (TCFA) versus those with thick cap fibroatheroma, in ruptured coronary plaques versus non-ruptured coronary plaques, in culprit versus non-culprit lesions and in lipid-rich versus non-lipid-rich plaques.<bold>Results:</bold> A total of 1,568 coronary plaques in 1,225 patients with acute coronary syndromes (ACS) who underwent both IVUS and OCT for analysis of plaque features were included in the final analysis. The review identified the following IVUS-derived features as significantly correlated with plaque vulnerability: plaque burden (p &lt;0.001), remodeling index (p &lt;0.001), external elastic membrane cross-sectional area (p &lt;0.001), and the amount of necrotic core (p &lt;0.001), while OCT-derived features characterizing unstable plaque were TCFA (p &lt;0.001), lipid arch (p &lt;0.001), accumulation of macrophages (p = 0.03), and presence of intracoronary thrombus (p &lt;0.001).<bold>Conclusion:</bold> Both IVUS and OCT are invasive imaging techniques able to provide relevant information on the vulnerability of coronary atheromatous plaques, identifying, as they do, various plaque features significantly associated with unstable plaques. Information provided by the two techniques is complementary, and both methods can serve as a useful clinical diagnostic tool, especially in cases of ACS patients undergoing a revascularization procedure.</abstract>

The aim of this systematic review was to analyze studies characterizing vulnerable coronary plaques using optical coherence tomography (OCT) and intravascular ultrasound (IVUS), in order to identify the most efficient invasive technique permitting plaque characterization in patients with acute myocardial infarction.Method: A total number of 432 studies were identified, 420 through database searching and 12 through manual searching. Eight duplicate studies were removed, leaving a total number of 424 studies to be screened. Twenty-six studies only available in Abstract-only form were excluded, resulting in 398 studies checked for eligibility. Eleven studies fulfilled the eligibility criteria and were included in this systematic analysis. Plaque vulnerability was investigated in plaques with thin cap fibroatheroma (TCFA) versus those with thick cap fibroatheroma, in ruptured coronary plaques versus non-ruptured coronary plaques, in culprit versus non-culprit lesions and in lipid-rich versus non-lipid-rich plaques.Results: A total of 1,568 coronary plaques in 1,225 patients with acute coronary syndromes (ACS) who underwent both IVUS and OCT for analysis of plaque features were included in the final analysis. The review identified the following IVUS-derived features as significantly correlated with plaque vulnerability: plaque burden (p <0.001), remodeling index (p <0.001), external elastic membrane cross-sectional area (p <0.001), and the amount of necrotic core (p <0.001), while OCT-derived features characterizing unstable plaque were TCFA (p <0.001), lipid arch (p <0.001), accumulation of macrophages (p = 0.03), and presence of intracoronary thrombus (p <0.001).Conclusion: Both IVUS and OCT are invasive imaging techniques able to provide relevant information on the vulnerability of coronary atheromatous plaques, identifying, as they do, various plaque features significantly associated with unstable plaques. Information provided by the two techniques is complementary, and both methods can serve as a useful clinical diagnostic tool, especially in cases of ACS patients undergoing a revascularization procedure.

Assessment of Coronary Plaque Vulnerability in Acute Coronary Syndromes using Optical Coherence Tomography and Intravascular Ultrasound. A Systematic Review

Department of Cardiology, University of Medicine and Pharmacy, Tîrgu Mureş,

Journal of Cardiovascular Emergencies

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

The aim of this systematic review was to analyze studies characterizing vulnerable coronary plaques using optical coherence tomography (OCT) and intravascular...

Assessment of Coronary Plaque Vulnerability in Acute Coronary Syndromes using Optical Coherence Tomography and Intravascular Ultrasound. A Systematic Review

Published Online: Dec 30, 2016

Page range: 173 - 184

Received: Oct 10, 2016

Accepted: Nov 20, 2016

DOI: https://doi.org/10.1515/jce-2016-0028

Keywords
vulnerable plaque, acute coronary syndrome, invasive coronary imaging, culprit plaque

© 2016 Theodora Benedek et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Assessment of Coronary Plaque Vulnerability in Acute Coronary Syndromes using Optical Coherence Tomography and Intravascular Ultrasound. A Systematic Review

Published Online: Dec 30, 2016

Page range: 173 - 184

Received: Oct 10, 2016

Accepted: Nov 20, 2016

DOI: https://doi.org/10.1515/jce-2016-0028

Keywordsvulnerable plaque, acute coronary syndrome, invasive coronary imaging, culprit plaque

© 2016 Theodora Benedek et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
vulnerable plaque, acute coronary syndrome, invasive coronary imaging, culprit plaque