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Abstract：
OBJECTIVE: This study was designed to utilize frequency-domain optical coherence tomography (FD-OCT) for assessment of plaque characteristics and vulnerability in patients with acute coronary syndrome (ACS) compared to stable coronary artery disease (SCAD).
RESULTS: We enrolled 48 patients; divided into an ACS-group (27 patients) and SCAD-group (21 patients) according to their clinical presentation. Hypertension and diabetes mellitus were more prevalent in SCAD group. Patients with ACS showed higher frequency of lipid-rich plaques (96.3% vs. 66.7%, P = .015), lower frequency of calcium plaques (7.4% vs. 57.1%, P < .001), and fibrous plaques (14.8% vs. 81%, P < .001) when compared with SCAD patients. The TCFA (defined as lipid-rich plaque with cap thickness <65 μm) identified more frequently (33.3% vs. 14.3%, P = .185), with a trend towards thinner median fibrous cap thickness (70 (50-180) µm vs. 100 (50-220) µm, P = .064) in ACS group. Rupture plaque (52% vs. 14.3%, P = .014), plaque erosion (18.5% vs. 0%, P = .059) and intracoronary thrombus (92.6% vs. 14.3%, P < .001) were observed more frequently in ACS group, while cholesterol crystals were identified frequently in patients with SCAD (0.0% vs. 33.3%, P = .002).
CONCLUSIONS: The current FD-OCT study demonstrated the differences of plaque morphology and identified distinct lesion characteristics between patients with ACS and those with SCAD. These findings could explain the clinical presentation of patients in both groups.
RESULTS: We enrolled 48 patients; divided into an ACS-group (27 patients) and SCAD-group (21 patients) according to their clinical presentation. Hypertension and diabetes mellitus were more prevalent in SCAD group. Patients with ACS showed higher frequency of lipid-rich plaques (96.3% vs. 66.7%, P = .015), lower frequency of calcium plaques (7.4% vs. 57.1%, P < .001), and fibrous plaques (14.8% vs. 81%, P < .001) when compared with SCAD patients. The TCFA (defined as lipid-rich plaque with cap thickness <65 μm) identified more frequently (33.3% vs. 14.3%, P = .185), with a trend towards thinner median fibrous cap thickness (70 (50-180) µm vs. 100 (50-220) µm, P = .064) in ACS group. Rupture plaque (52% vs. 14.3%, P = .014), plaque erosion (18.5% vs. 0%, P = .059) and intracoronary thrombus (92.6% vs. 14.3%, P < .001) were observed more frequently in ACS group, while cholesterol crystals were identified frequently in patients with SCAD (0.0% vs. 33.3%, P = .002).
CONCLUSIONS: The current FD-OCT study demonstrated the differences of plaque morphology and identified distinct lesion characteristics between patients with ACS and those with SCAD. These findings could explain the clinical presentation of patients in both groups.
摘要：
目的：本研究旨在利用频域光学相干断层扫描（FD-OCT）评估急性冠状动脉综合征（ACS）患者与稳定性冠状动脉疾病（SCAD）患者的斑块特征和易损性。
结果：我们招募了48例患者，根据其临床表现分为ACS组（27例）和SCAD组（21例）。高血压和糖尿病在SCAD组中更为普遍。ACS患者表现出较高的富含脂质斑块的频率（96.3％vs.66.7%,P=.015)，钙斑块的频率较低(7.4%vs.57.1%,P<.001),和纤维斑块(14.8%vs.81%,与SCAD患者相比，P<.001）。TCFA（定义为帽厚度<65μm的富含脂质的斑块）被更频繁地识别（33.3％vs.14.3%,P=.185），纤维帽厚度中位数有变薄的趋势(70(50-180)µm与100(50-220)µm,P=.064）在ACS组中。破裂斑块（52%vs.14.3%,P=.014)，斑块糜烂（18.5%vs.0%,P=0.059）和冠状动脉内血栓（92.6%vs.14.3%,P<.001）在ACS组中观察到更频繁，而胆固醇晶体在SCAD患者中经常被发现(0.0%vs.33.3%,P=.002）。
结论：当前的FD-OCT研究显示了ACS患者和SCAD患者之间斑块形态的差异，并确定了不同的病变特征。这些发现可以解释两组患者的临床表现。
结果：我们招募了48例患者，根据其临床表现分为ACS组（27例）和SCAD组（21例）。高血压和糖尿病在SCAD组中更为普遍。ACS患者表现出较高的富含脂质斑块的频率（96.3％vs.66.7%,P=.015)，钙斑块的频率较低(7.4%vs.57.1%,P<.001),和纤维斑块(14.8%vs.81%,与SCAD患者相比，P<.001）。TCFA（定义为帽厚度<65μm的富含脂质的斑块）被更频繁地识别（33.3％vs.14.3%,P=.185），纤维帽厚度中位数有变薄的趋势(70(50-180)µm与100(50-220)µm,P=.064）在ACS组中。破裂斑块（52%vs.14.3%,P=.014)，斑块糜烂（18.5%vs.0%,P=0.059）和冠状动脉内血栓（92.6%vs.14.3%,P<.001）在ACS组中观察到更频繁，而胆固醇晶体在SCAD患者中经常被发现(0.0%vs.33.3%,P=.002）。
结论：当前的FD-OCT研究显示了ACS患者和SCAD患者之间斑块形态的差异，并确定了不同的病变特征。这些发现可以解释两组患者的临床表现。
