Vulnerable atherosclerotic plaque features: findings from coronary imaging

Osamu Kurihara; Masamichi Takano; Yasushi Miyauchi; Kyoichi Mizuno; Wataru Shimizu

doi:10.11909/j.issn.1671-5411.2021.07.005

Volume 18 Issue 7

Jul. 2021

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Article Navigation > Journal of Geriatric Cardiology > 2021 > 18(7): 577-584

Please cite this article as: Kurihara O, Takano M, Miyauchi Y, Mizuno K, Shimizu W. Vulnerable atherosclerotic plaque features: findings from coronary imaging. J Geriatr Cardiol 2021; 18(7): 577−584. DOI: 10.11909/j.issn.1671-5411.2021.07.005

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Please cite this article as: Kurihara O, Takano M, Miyauchi Y, Mizuno K, Shimizu W. Vulnerable atherosclerotic plaque features: findings from coronary imaging. J Geriatr Cardiol 2021; 18(7): 577−584. DOI: 10.11909/j.issn.1671-5411.2021.07.005

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Vulnerable atherosclerotic plaque features: findings from coronary imaging

doi: 10.11909/j.issn.1671-5411.2021.07.005

1.
Cardiovascular Center, Chiba Hokusoh Hospital, Nippon Medical School, Chiba, Japan
2.
Mitsukoshi Health and Welfare Foundation, Tokyo, Japan
3.
Division of Cardiology, Nippon Medical School, Tokyo, Japan

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Corresponding author: takanom@nms.ac.jp
Available Online: 2021-06-08
Publish Date: 2021-07-28

Abstract

Abstract

Pathological studies have suggested that features of vulnerable atherosclerotic plaques likely to progress and lead to acute cardiovascular events have specific characteristics. Given the progress of intravascular coronary imaging technology, some large prospective studies have detected features of vulnerable atherosclerotic plaques using these imaging modalities. However, the rate of cardiovascular events, such as acute coronary syndrome, has been found to be considerably reduced in the limited follow-up period available in the statin era. Additionally, not all disrupted plaques lead to thrombus formation with clinical presentation. If sub-occlusive or occlusive thrombus formation does not occur, a thrombus on a disrupted plaque will organize without any symptoms, forming a “healed plaque”. Although vulnerable plaque detection using intracoronary imaging is focused on “thin-cap fibroatheroma” leading to plaque rupture, superficial plaque erosion is increasingly recognized; however, the underlying mechanism of thrombus formation on eroded plaques is not well understood. One of intravascular imaging, optical coherence tomography (OCT) has the highest image resolution and has enabled detailed characterization of the plaque in vivo. Here, we reviewed the status and limitations of intravascular imaging in terms of detecting vulnerable plaque through mainly OCT studies. We suggested that vulnerable plaque should be reconsidered in terms of eroded plaque and healed plaque and that both plaque and circulating blood should be assessed in greater detail accordingly.

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References(69)

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