Aims: Coronary lesions precursors of acute events remain elusive, since they undergo continuous changes and their temporal changes are not very well-characterized. In natural history studies, optical frequency domain imaging (OFDI) has been used only to assess fibroatheromas as a 2D structure and sometimes in a single frame fashion. We aim at describing the serial volumetric modifications of the fibrous cap (FC) of the fibroatheromas as determined by OFDI over a 6-month follow-up period.
Methods and results: In 49 patients, OFDI investigation was performed following treatment of culprit lesion and at 6-month follow-up in patients with ST-segment elevation myocardial infarction (STEMI). A fully automatic volumetric quantification of FC was done in all lipid-containing frames of non-culprit lesions in the infarct related artery. These lesions were matched at baseline and 6-month follow-up. A total of 58 non-culprit lipid rich lesions (34 TCFAs and 24 thick-cap fibroatheroma [ThCFA]) were found in 34 patients at baseline. Overall, there was a FC volume decrease of 1.57 (Inter-quartile Range [IQR] '4.13 to 0.54) mm 3 at 6-months. 27% of the lesions changed their phenotype over time (TCFA or ThCFA). TCFAs that became ThCFAs at follow-up had smaller mean and maximal FC as compared with lesions that remained TCFAs (P = 0.01 for both).
Conclusions: Non-culprit fibroatheromas located in the infarct related artery of patients with STEMI had a volumetric reduction of the FC after 6-month follow-up. Quantitative FC assessment was able to differentiate high-risk lesions that became ThCFAs. There was a considerable change of plaque phenotype (TCFAs or ThCFAs) over time. Published on behalf of the European Society of Cardiology. All rights reserved.

Additional Metadata
Keywords atherosclerosis, optical coherence tomography, thin-cap fribroatheroma, vulnerable plaque
Persistent URL dx.doi.org/10.1093/ehjci/jew338, hdl.handle.net/1765/103943
Journal European Heart Journal Cardiovascular Imaging
Citation
Campos, C.A.M, Garcia-Garcia, H.M, Iqbal, J, Muramatsu, T, Nakatani, T, Dijkstra, J, … Serruys, P.W.J.C. (2018). Serial volumetric assessment of coronary fibroatheroma by optical frequency domain imaging: Insights from the TROFI trial. European Heart Journal Cardiovascular Imaging, 19(1), 92–100. doi:10.1093/ehjci/jew338