Aims: There is limited in vivo evidence regarding the temporal evolution of non-culprit coronary plaque morphology. We aimed to evaluate changes in non-culprit plaque morphology over time by optical coherence tomography (OCT).
Methods and results: Seventy-two (72) patients with 257 non-culprit segments with serial OCT studies were analysed. Non-culprit 5 mm-long coronary segments from the same imaged region were matched between baseline and follow-up. OCT plaque characterisation including automated attenuation analysis was performed, and changes over a median follow-up of 6.2 months were evaluated. On segment level, lumen area decreased from baseline to follow-up, whereas fibrous cap thickness increased. Similarly, plaque attenu ation indices at follow-up were significantly decreased. Minimal cap thickness per patient did not change. In 68.5% of segments, plaque morphology did not change. Favourable change was observed in 18.4% of segments and unfavourable in 12.9%. There were no robust clinical predictors of change in plaque morphology. Attenuation analysis supported the qualitative characterisation, showing significantly different attenuation between different plaque types.
Conclusions: In non-culprit coronary segments of patients with coronary artery disease under standard medical therapy, segment-level but not patient-level minimum fibrous cap thickness increases over time, with observations of both favourable and unfavourable changes in individual segments.

Coronary artery disease, Optical coherence tomography, Plaque rupture,
Department of Cardiology

Zhang, B.-C, Karanasos, A, Gnanadesigan, M, van der Sijde, J, van Ditzhuijzen, N.S, Witberg, K.Th, … Regar, E.S. (2018). Qualitative and quantitative evaluation of dynamic changes in non-culprit coronary atherosclerotic lesion morphology. EuroIntervention, 13(18), e2190–e2200. doi:10.4244/EIJ-D-17-00161