1. Articles from shaosong zhang

    1-24 of 37 1 2 »
    1. Pre-infarction Angina and Culprit Lesion Morphologies in Patients with a First ST-segment Elevation Acute Myocardial Infarction: Insights from In Vivo Optical Coherence Tomography

      Pre-infarction Angina and Culprit Lesion Morphologies in Patients with a First ST-segment Elevation Acute Myocardial Infarction: Insights from In Vivo Optical Coherence Tomography

      Aims: This study aimed to evaluate the relationship between pre-infarction angina (PIA) and in vivo culprit lesion characteristics as assessed by intravascular optical coherence tomography (OCT) in patients with a first ST-segment elevation myocardial infarction (STEMI). Methods and results: A total of 305 consecutive patients with a first STEMI who underwent OCT imaging of culprit lesions during primary percutaneous coronary intervention (PCI) were prospectively enrolled. OCT findings of the culprit plaque were compared between patients with (n=206) and without PIA (n=99). Patients with PIA showed lower rates of thin-cap fibroatheroma (TCFA) (62.6% vs. 80.8%, P=0 ...

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    2. In vivo predictors of plaque erosion in patients with ST-segment elevation myocardial infarction: a clinical, angiographical, and intravascular optical coherence tomography study

      In vivo predictors of plaque erosion in patients with ST-segment elevation myocardial infarction: a clinical, angiographical, and intravascular optical coherence tomography study

      Aims Plaque erosion is a significant substrate of acute coronary thrombosis. This study sought to determine in vivo predictors of plaque erosion in patients with ST-segment elevation myocardial infarction (STEMI). Methods and results A prospective series of 822 STEMI patients underwent pre-intervention optical coherence tomography. Using established diagnostic criteria, 209 had plaque erosion (25.4%) and 564 had plaque rupture (68.6%). Plaque erosion was more frequent in women <50 years when compared with those ≥50 years of age ( P  = 0.009). There was a similar, but less striking, trend in men ( P  = 0.011). Patients with plaque erosion were ...

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    3. Does spotty calcification attenuate the response of nonculprit plaque to statin therapy?: A serial optical coherence tomography study

      Does spotty calcification attenuate the response of nonculprit plaque to statin therapy?: A serial optical coherence tomography study

      Objectives The aim of this study was to determine if spotty calcification decreases the response of plaque progression to statin therapy. Background Previous studies showed that the presence of spotty calcification is a marker of vulnerable plaque. However, the relationship between spotty calcification and plaque progression is not clear. Methods Ninety-six nonculprit lipid-rich plaques in 69 patients who received serial optical coherence tomography (OCT) imaging were included. Plaques were divided into three groups: spotty calcification ( n = 38), calcified ( n = 12) and noncalcified ( n = 46) plaques. Spotty calcification was identified by the presence of a lesion <4 mm in length with ...

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    4. EROSION Study (Effective Anti-Thrombotic Therapy Without Stenting: Intravascular Optical Coherence Tomography–Based Management in Plaque Erosion)

      EROSION Study (Effective Anti-Thrombotic Therapy Without Stenting: Intravascular Optical Coherence Tomography–Based Management in Plaque Erosion)

      Background— The initial EROSION study (Effective Anti-Thrombotic Therapy Without Stenting: Intravascular Optical Coherence Tomography–Based Management in Plaque Erosion) demonstrated that patients with acute coronary syndrome caused by plaque erosion might be stabilized with aspirin and ticagrelor without stenting for ≤1 month. However, a long-term evaluation of outcomes is lacking. The aim of this study was to assess whether the initial benefit of noninterventional therapy for patients with acute coronary syndrome caused by plaque erosion is maintained for ≤1 year. Methods and Results— Among 53 patients who completed clinical follow-up, 49 underwent repeat optical coherence tomography imaging at 1 year ...

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    5. Clinical Significance of Lipid-Rich Plaque Detected by Optical Coherence Tomography : A 4-Year Follow-Up Study

      Clinical Significance of Lipid-Rich Plaque Detected by Optical Coherence Tomography : A 4-Year Follow-Up Study

      Background Lipid-rich plaque (LRP) is thought to be a precursor to cardiac events. However, its clinical significance in coronary arteries has never been systematically investigated. Objectives This study investigated the prevalence and clinical significance of LRP in the nonculprit region of the target vessel in patients undergoing percutaneous coronary intervention (PCI). Methods The study included 1,474 patients from 20 sites across 6 countries undergoing PCI, who had optical coherence tomography (OCT) imaging of the target vessel. Major adverse cardiac events (MACE) were defined as a composite of cardiac death, acute myocardial infarction, and ischemia-driven revascularization. Patients were followed for ...

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    6. Impact of statins therapy on morphological changes in lipid-rich plaques stratified by 10-Year framingham risk score: A serial optical coherence tomography study

      Impact of statins therapy on morphological changes in lipid-rich plaques stratified by 10-Year framingham risk score: A serial optical coherence tomography study

      The aim of the study was to investigate the impact of statins therapy on morphological changes of lipid-rich plaques by OCT (optical coherence tomography) in patients with known CHD (coronary heart disease), stratified by FRS. Ninety-seven lipid-rich plaques from sixty-nine patients who received statins therapy and underwent serial OCT images (baseline, 6-month and 12-month) were divided into 2 groups according to the FRS (framingham risk score): low risk group A (FRS<10%, N=35, n=45), moderate to high risk group B (FRS≥10%, N=34, n=52). Fibrous cap thickness (FCT) was measured at its thinnest part 3 times ...

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    7. Chronic total occlusion is associated with a higher incidence of malapposition and uncovered stent struts: OCT findings at 6 months following DES implantation

      Chronic total occlusion is associated with a higher incidence of malapposition and uncovered stent struts: OCT findings at 6 months following DES implantation

      Objectives To compare stent coverage and malapposition in patients with chronic total occlusion (CTO) lesions and non-CTO lesions (including lipid-rich plaque [LRP] and non-lipid-rich plaque [non-LRP]) after drug-eluting stent (DES) implantation by optical coherence tomography (OCT). Background Different initial lesion characteristics may be related to heterogeneous vessel responses after DES implantation. However, the vessel response in patients with CTO and non-CTO lesions after stenting is unclear. Methods We retrospectively enrolled 64 patients with 68 target lesions. All of the patients underwent OCT imaging immediate after stenting and 6 months after stenting. LRP was defined as the plaque with lipid content ...

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    8. Management and Outcome of Patients With Acute Coronary Syndrome Caused by Plaque Rupture Versus Plaque Erosion: An Intravascular Optical Coherence Tomography Study

      Management and Outcome of Patients With Acute Coronary Syndrome Caused by Plaque Rupture Versus Plaque Erosion: An Intravascular Optical Coherence Tomography Study

      Background Plaque rupture and erosion are the 2 most common mechanisms for acute coronary syndromes. However, the outcome of these 2 distinct pathologies in patients with acute coronary syndromes has never been studied. Methods and Results We retrospectively studied 141 patients with acute coronary syndromes who underwent optical coherence tomography ( OCT ) imaging of the culprit lesion prior to stenting from the Massachusetts General Hospital OCT Registry. Management (stent versus no stent), poststent OCT findings, and outcomes were compared. Among the 141 culprit lesions, rupture was found in 79 (56%) patients and erosion in 62 (44%). Stent implantation was performed in ...

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    9. Is age an important factor for vascular response to statin therapy? A serial optical coherence tomography and intravascular ultrasound study

      Is age an important factor for vascular response to statin therapy? A serial optical coherence tomography and intravascular ultrasound study

      Objective: Age-related structural and functional changes in vessel wall may affect the time course of vascular response to statin therapy. In this study, we sought to compare the response of lipid-rich plaque to statin therapy in elderly versus younger patients using optical coherence tomography and intravascular ultrasound. Patients and methods: Sixty-nine patients who underwent serial optical coherence tomography and intravascular ultrasound at the time point of baseline, 6, and 12 months were divided into two groups according to median age: group A (age<57 years, n=35) and group B (age>=57 years, n=34). Patients were treated with intensive ...

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    10. Chronic kidney disease predicts coronary plaque vulnerability: an optical coherence tomography study

      Chronic kidney disease predicts coronary plaque vulnerability: an optical coherence tomography study

      Objective: The addition of cystatin C to creatinine in calculating the estimated glomerular filtration rate (eGFR) is known to improve the risk prediction for cardiovascular events. We sought to investigate the associations between eGFRs calculated by three Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations and coronary plaque phenotype by optical coherence tomography. Patients and methods: We analyzed 181 nonculprit plaques from 116 coronary artery disease patients. For each patient, the eGFR was calculated using the CKD-EPIcreatinine, CKD-EPIcystatin C, and CKD-EPIcombination equations. Patients were divided into three categories according to the eGFR calculated by each equation (>=90, 60-89, and <60 ml ...

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    11. Effective anti-thrombotic therapy without stenting: intravascular optical coherence tomography-based management in plaque erosion (the EROSION study)

      Effective anti-thrombotic therapy without stenting: intravascular optical coherence tomography-based management in plaque erosion (the EROSION study)

      Aims Plaque erosion, compared with plaque rupture, has distinctly different underlying pathology and therefore may merit tailored therapy. In this study, we aimed to assess whether patients with acute coronary syndrome (ACS) caused by plaque erosion might be stabilized by anti-thrombotic therapy without stent implantation. Methods and results This was a single-centre, uncontrolled, prospective, proof-of concept study. Patients with ACS including ST-segment elevation myocardial infarction were prospectively enrolled. If needed, aspiration thrombectomy was performed. Patients diagnosed with plaque erosion by optical coherence tomography (OCT) and residual diameter stenosis <70% on coronary angiogram were treated with anti-thrombotic therapy without stenting. OCT ...

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    12. Evaluation of the characterization of thrombi in vitro by optical coherence tomography

      Evaluation of the characterization of thrombi in vitro by optical coherence tomography

      Aim The purpose of this study was to provide a new assessable method of the optical coherence tomography (OCT) in characterization of thrombi with different concentrations of red blood cell (RBC). Methods and results A series of thrombus models were constructed by using human blood in vitro. The thrombi were made by using human blood with different concentration of RBC (from 1% to 35%). Then tip of an FD-OCT catheter was put on the top of the thrombus to scan. After OCT being performed, all the acquired images were processed by a newly developed software to analyze the RBC levels ...

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    13. Serial Optical Coherence Tomography and Intravascular Ultrasound Analysis of Gender Difference in Changes of Plaque Phenotype in Response to Lipid-lowering Therapy

      Serial Optical Coherence Tomography and Intravascular Ultrasound Analysis of Gender Difference in Changes of Plaque Phenotype in Response to Lipid-lowering Therapy

      Although the clinical benefit of statins have been demonstrated in both genders, gender differences in the response to statin therapy on plaque morphological changes have not been reported. A total of 66 non-culprit plaques from 46 patients who had serial image acquisition at baseline, 6 months, and 12 months by both optical coherence tomography (OCT) and intravascular ultrasound (IVUS) were included. Patients were treated with atorvastatin 60mg (AT60) or 20mg (AT20). The baseline characteristics were similar between women (n=16) and men (n=30) except for age (59.3±6.8 vs. 52.5±10.6, years, P=0.027 ...

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    14. Impact of Age on Stent Strut Coverage and Neointimal Remodeling as Assessed by Optical Coherence Tomography

      Impact of Age on Stent Strut Coverage and Neointimal Remodeling as Assessed by Optical Coherence Tomography

      Abstract: While older age associates with adverse percutaneous coronary intervention (PCI) outcomes, detailed information relating age to stent strut coverage and neointimal characteristics is lacking. One hundred nineteen patients with 123 sirolimus-eluting stents (SESs) were divided into 3 groups: group A (≤55 years), group B (56–65 years), and group C (>65 years). At 6 and 12 months of follow-up, optical coherence tomography was performed to assess strut coverage and neointimal remodeling. At 6 months, the proportion of uncovered struts increased with age: 6.1% in group A versus 7.3% in group B versus 11.7% in group C ...

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    15. Comparison of Intensive versus Moderate Lipid-lowering Therapy on Fibrous Cap and Atheroma Volume of Coronary Lipid-rich Plaque Using Serial Optical Coherence Tomography and Intravascular Ultrasound Imaging

      Comparison of Intensive versus Moderate Lipid-lowering Therapy on Fibrous Cap and Atheroma Volume of Coronary Lipid-rich Plaque Using Serial Optical Coherence Tomography and Intravascular Ultrasound Imaging

      Despite marked clinical benefit, reduction in atheroma volume with statin therapy is minimal. Changes in plaque composition may explain this discrepancy. We aimed in the present study to assess the effect of statin therapy on coronary plaque composition as well as plaque volume using serial multimodality imaging. From an open-label, single-blinded study, patients with angiographically mild to moderate lesion were randomized to receive atorvastatin 60 (AT 60) mg or atorvastatin 20 (AT 20) mg for 12 months. Optical coherence tomography (OCT) was used to assess fibrous cap thickness (FCT) and intravascular ultrasound (IVUS) to assess atheroma burden at three time ...

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    16. Incidence and Clinical Significance of Poststent Optical Coherence Tomography Findings: One-Year Follow-Up Study From a Multicenter Registry

      Incidence and Clinical Significance of Poststent Optical Coherence Tomography Findings: One-Year Follow-Up Study From a Multicenter Registry

      Background— Optical coherence tomography (OCT) was recently introduced to optimize percutaneous coronary intervention. However, the exact incidence and significance of poststent OCT findings are unknown. Methods and Results— A total of 900 lesions treated with 1001 stents in 786 patients who had postprocedure OCT imaging were analyzed to evaluate the incidence of poststent OCT findings and to identify the OCT predictors for device-oriented clinical end points, including cardiac death, target vessel–related myocardial infarction, target lesion revascularization, and stent thrombosis. Patients were followed up to 1 year. Stent edge dissection was detected in 28.7% of lesions, and incomplete stent ...

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    17. Incidence and Clinical Significance of Post-Stent OCT Findings: One Year Follow-Up Study From a Multicenter Registry

      Incidence and Clinical Significance of Post-Stent OCT Findings: One Year Follow-Up Study From a Multicenter Registry

      Background —Optical coherence tomography (OCT) was recently introduced to optimize percutaneous coronary intervention. However, the exact incidence and significance of post-stent OCT findings are unknown. Methods and Results —A total of 900 lesions treated with 1001 stents in 786 patients who had post-procedure OCT imaging were analyzed to evaluate the incidence of post-stent OCT findings and to identify the OCT predictors for device-oriented clinical endpoints (DoCE), including cardiac death, target vessel-related myocardial infarction, target lesion revascularization (TLR) and stent thrombosis. Patients were followed up to 1 year. Stent edge dissection was detected in 28.7% of lesions and incomplete stent ...

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    18. Pancoronary Plaque Vulnerability in Patients with Acute Coronary Syndrome and Ruptured Culprit Plaque: A Three-Vessel Optical Coherence Tomography Study

      Pancoronary Plaque Vulnerability in Patients with Acute Coronary Syndrome and Ruptured Culprit Plaque: A Three-Vessel Optical Coherence Tomography Study

      Background Recent studies described different clinical and underlying plaque characteristics between patients with and without plaque rupture presenting with acute coronary syndrome (ACS). In light of the systemic nature of atherosclerosis, we hypothesized that non-culprit plaques might also express different morphological features in these two groups of patients. Methods Thirty-eight patients with ACS who underwent 3-vessel optical coherence tomography (OCT) imaging were identified from the Massachusetts General Hospital OCT Registry. Based on culprit plaque morphology, the study population was divided into two groups: patients with plaque rupture at the culprit lesion (Group 1), and patients with non-ruptured plaque at the ...

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    19. OCT Compared With IVUS in a Coronary Lesion Assessment The OPUS-CLASS Study

      OCT Compared With IVUS in a Coronary Lesion Assessment The OPUS-CLASS Study

      The aim of this study was to investigate the reliability of frequency domain optical coherence tomography (FD-OCT) for coronary measurements compared with quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS). Background Accurate luminal measurement is expected in FD-OCT because this technology offers high resolution and excellent contrast between lumen and vessel wall. Methods In 5 medical centers, 100 patients with coronary artery disease were prospectively studied by using angiography, FD-OCT, and IVUS. In addition, 5 phantom models of known lumen dimensions (lumen diameter 3.08 mm; lumen area 7.45 mm 2 ) were examined using FD-OCT and IVUS. Quantitative image ...

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    20. Features of Coronary Plaque in Patients with Metabolic Syndrome and Diabetes Mellitus Assessed by 3-vessel Optical Coherence Tomography

      Features of Coronary Plaque in Patients with Metabolic Syndrome and Diabetes Mellitus Assessed by 3-vessel Optical Coherence Tomography

      Background —The pathophysiologic basis for the association between metabolic syndrome (MetS) and coronary artery disease is not well understood. We sought to characterize coronary plaques in patients with MetS using optical coherence tomography (OCT). Methods and Results —We identified 451 coronary plaques from 171 subjects who underwent OCT imaging in three coronary arteries. Subjects were divided into 3 groups: diabetes mellitus (DM, n=77), MetS (n=35), and a control group (C group, n=59) without DM or MetS. OCT analysis included the presence of lipid-rich plaque, maximum lipid arc, lipid-core length (LL), lipid index (LI), fibrous cap thickness (FCT ...

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    21. Feature Of The Week 8/4/13: MGH OCT Registry Reports on In Vivo OCT Studies of Plaque Erosion and Calcified Nodule In Acute Coronary Syndrome

      Feature Of The Week 8/4/13: MGH OCT Registry Reports on In Vivo OCT Studies of Plaque Erosion and Calcified Nodule In Acute Coronary Syndrome

      Pathology studies reported that three most common causes of acute coronary syndrome (ACS) or sudden cardiac death are plaque rupture, plaque erosion and calcified nodules. The morphological and clinical characteristics of the underlying pathology of ACS, especially plaque erosion and calcified nodule, have never been well studied in vivo. Using optical coherence tomography, we found that plaque erosions are the substrate for ACS in 31% of patients and calcified nodules in 8% of patients, which are consistent with pathological findings. Erosions are more likely to cause non-ST-segment elevation ACS than ST-segment elevation myocardial infarction. Compared to plaque rupture, plaque erosion ...

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    22. Correlation Between Degree of Neointimal Hyperplasia and Incidence and Characteristics of Neoatherosclerosis as Assessed by Optical Coherence Tomography

      Correlation Between Degree of Neointimal Hyperplasia and Incidence and Characteristics of Neoatherosclerosis as Assessed by Optical Coherence Tomography

      Emerging evidence suggests that neointimal degenerative changes with development of neoatherosclerosis (NA) may represent an important mechanism for late stent failure. The aim of the present study was to investigate the relation between degree of neointimal hyperplasia and incidence and characteristics of NA using optical coherence tomography. We identified a total of 252 stents with mean neointimal thickness (NIT) >100 μm in 212 patients: 100 bare metal stents (BMSs) and 152 drug-eluting stents (DESs). Based on the values of mean NIT, we divided stents into tertiles and compared neointimal characteristics among the 3 groups. NA was defined as the presence ...

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    23. Optical Coherence Tomographic Observations of Polytetrafluoroethylene-Covered Sirolimus-Eluting Coronary Arterial Stent

      Optical Coherence Tomographic Observations of Polytetrafluoroethylene-Covered Sirolimus-Eluting Coronary Arterial Stent

      The aim of this study was to evaluate neointimal coverage obtained using a new method of polytetrafluoroethylene-covered stent (PCS) implantation combined with underlying longer sirolimus-eluting stent (SES) implantation using optical coherence tomography. Nine patients were enrolled in this study, including patients with coronary artery perforations, original coronary aneurysms, and acquired coronary aneurysms after drug-eluting stent implantation. All patients were first treated with long SES implantation and then with focal PCS implantation. Postprocedural and follow-up angiographic and optical coherence tomographic examinations were performed in all patients, and intravascular ultrasound was performed in 5 patients. All patients were asymptomatic during follow-up, without ...

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    24. Comparison of Nonculprit Coronary Plaque Characteristics Between Patients With and Without Diabetes : A 3-Vessel Optical Coherence Tomography Study

      Comparison of Nonculprit Coronary Plaque Characteristics Between Patients With and Without Diabetes : A 3-Vessel Optical Coherence Tomography Study

      Objectives The aim of the present study was to compare the characteristics of nonculprit coronary plaques between diabetes mellitus (DM) and non-DM patients using 3-vessel optical coherence tomography (OCT) imaging. Background DM patients have a higher recurrent cardiovascular event rate. Methods Patients who had undergone 3-vessel OCT imaging were identified from the Massachusetts General Hospital OCT Registry. Characteristics of nonculprit plaques were compared between DM and non-DM patients. Results A total of 230 nonculprit plaques were identified in 98 patients. Compared with non-DM patients, DM patients had a larger lipid index (LI) (averaged lipid arc × lipid length; 778.6 ± 596 ...

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    1. (34 articles) Shaosong Zhang
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