1. Articles from Ik-Kyung Jang

    1-24 of 124 1 2 3 4 5 6 »
    1. Spatial Distribution of Vulnerable Plaques: Comprehensive In Vivo Coronary Plaque Mapping

      Spatial Distribution of Vulnerable Plaques: Comprehensive In Vivo Coronary Plaque Mapping

      Objectives The authors performed a comprehensive analysis on the distribution of coronary plaques with different phenotypes from our 3-vessel optical coherence tomography (OCT) database. Background Previous pathology studies demonstrated that thin-cap fibroatheroma (TCFA) is localized in specific segments of the epicardial coronary arteries. A detailed description of in vivo coronary plaques of various phenotypes has not been reported. Methods OCT images of all 3 coronary arteries in 131 patients were analyzed every 1 mm to assess plaque phenotype and features of vulnerability. In addition, plaques were divided into tertiles according to percent area stenosis (%AS). Results Among 534 plaques identified ...

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    2. High Spatial Endothelial Shear Stress Gradient Independently Predicts Site of Acute Coronary Plaque Rupture and Erosion

      High Spatial Endothelial Shear Stress Gradient Independently Predicts Site of Acute Coronary Plaque Rupture and Erosion

      Aims To investigate local haemodynamics in the setting of acute coronary plaque rupture and erosion. Methods and Results Intracoronary optical coherence tomography performed in 37 patients with acute coronary syndromes caused by plaque rupture (n = 19) or plaque erosion (n = 18) was used for 3D reconstruction and computational fluid dynamic simulation. Endothelial shear stress (ESS), spatial ESS gradient (ESSG), and oscillatory shear index (OSI) were compared between plaque rupture and erosion through mixed-effects logistic regression. Lipid, calcium, macrophages, layered plaque, and cholesterol crystals were also analysed. By multivariable analysis, only high ESSG (odds ratio [OR] 5.29, 95% confidence interval ...

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    3. Relation of Low-Density Lipoprotein Cholesterol Level to Plaque Rupture

      Relation of Low-Density Lipoprotein Cholesterol Level to Plaque Rupture

      Statin therapy reduces low-density lipoprotein cholesterol (LDL-C), inflammation, and atherosclerotic cardiovascular disease. We investigated the association between LDL-C and statin therapy on the prevalence of plaque rupture (PR). Patients with acute coronary syndromes who underwent optical coherence tomography imaging of the culprit lesion were divided into 4 groups based on LDL-C level and statin use (Group 1: LDL-C ≤ 100 without statin; Group 2; LDL-C ≤ 100 with statin; Group 3: LDL-C >100 with statin; Group 4: LDL-C >100 without statin), and the prevalence of PR was compared between the groups. Among 896 patients, PR was diagnosed in 444 (49.6%) patients ...

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    4. Circadian variations in pathogenesis of ST-segment elevation myocardial infarction: an optical coherence tomography study

      Circadian variations in pathogenesis of ST-segment elevation myocardial infarction: an optical coherence tomography study

      Previous studies have reported a circadian variation in the onset of ST-segment elevation myocardial infarction (STEMI). However, underlying mechanisms for the circadian variation have not been fully elucidated. We investigated the relationship between onset of STEMI and the underlying pathology using optical coherence tomography (OCT). Patients with a diagnosis of STEMI were selected from a multicenter OCT registry. Patients were divided into 4 groups based on the estimated time of onset (00:00–05:59, 06:00–11:59, 12:00–17:59, or 18:00–23:59). Underlying pathologies of MI (plaque rupture, plaque erosion, and calcified plaque) were ...

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    5. Degree of luminal narrowing and composition of thrombus in plaque erosion

      Degree of luminal narrowing and composition of thrombus in plaque erosion

      As the degree of luminal narrowing increases, shear stress increases, and high shear stress is known to activate platelets. However, the relationship between the degree of luminal narrowing and the composition of thrombus in patients with plaque erosion has not been studied. A total of 148 patients with plaque erosion and thrombus detected by optical coherence tomography were divided into tertiles based on the minimum lumen area (MLA) at the culprit lesion. Thrombus was categorized as platelet-rich or fibrin-rich. Among 148 patients, 50 (34%) were in the mild stenosis group, 49 (33%) were in the moderate stenosis group, and 49 ...

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    6. Predictors for layered coronary plaques: an optical coherence tomography study

      Predictors for layered coronary plaques: an optical coherence tomography study

      Healed coronary plaques, morphologically characterized by a layered pattern, are signatures of previous plaque disruption and healing. Recent optical coherence tomography (OCT) studies showed that layered plaque is associated with vascular vulnerability. However, factors associated with layered plaques have not been studied. The aim of this study was to investigate predictors for layered plaque at the culprit plaques and at non-culprit plaques. Patients with coronary artery disease who underwent pre-intervention OCT imaging of the culprit lesion were included. Layered plaques were defined as plaques with one or more layers of different optical density and a clear demarcation from underlying components ...

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    7. COMPARISON OF POST STENT OPTICAL COHERENCE TOMOGRAPHY FINDINGS AMONG THREE SUBTYPES OF CALCIFIED CULPRIT PLAQUES IN PATIENTS WITH ACUTE CORONARY SYNDROME

      COMPARISON OF POST STENT OPTICAL COHERENCE TOMOGRAPHY FINDINGS AMONG THREE SUBTYPES OF CALCIFIED CULPRIT PLAQUES IN PATIENTS WITH ACUTE CORONARY SYNDROME

      Background Recently, three subtypes of calcified plaques at the culprit lesion were reported in patients with acute coronary syndrome (ACS): eruptive calcified nodule, superficial calcific sheet, and calcified protrusion. Methods A total of 157 patients with ACS and calcified plaque at the culprit lesion were selected from our database. Optical coherence tomography (OCT) findings at index procedure and after stent implantation were compared among the three subgroups. Results In the final analysis, 92 cases were included. Pre-procedural OCT showed eruptive calcified nodules in 20 (21.7%) cases, superficial calcific sheets in 66 (71.7%), and calcified protrusion in 6 (6 ...

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    8. Comprehensive In Vivo Coronary Plaque Mapping: A 3-Vessel Optical Coherence Tomography Study

      Comprehensive In Vivo Coronary Plaque Mapping: A 3-Vessel Optical Coherence Tomography Study

      Background Previous pathology studies demonstrated that thin-cap fibroatheroma (TCFA) is localized in specific segments of the epicardial coronary arteries. A detailed description of in vivo coronary plaques of various phenotypes has not been reported. Objectives We performed a comprehensive analysis on the distribution of coronary plaques with different phenotypes from our 3-vessel optical coherence tomography (OCT) database. Methods OCT images of all 3 coronary arteries in 131 patients were analyzed every 1 mm to assess plaque phenotype and features of vulnerability. In addition, plaques were divided into tertiles according to percent area stenosis (%AS). Results Among 534 plaques identified in ...

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    9. Early versus delayed treatment with ticagrelor on residual thrombus after percutaneous coronary intervention in patients presenting with non-ST-elevation acute coronary syndrome: an optical coherence tomography study

      Early versus delayed treatment with ticagrelor on residual thrombus after percutaneous coronary intervention in patients presenting with non-ST-elevation acute coronary syndrome: an optical coherence tomography study

      Ticagrelor, a P2Y12 antagonist, is well known for its rapid, high-potent inhibition of platelet aggregation by pharmacokinetic studies [ 1 ]. In the PLATO study, ticagrelor, compared to clopidogrel, reduced the incidence of myocardial infarction, stroke, cardiovascular death and definite stent thrombosis, during 12-month follow-up in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) [ 2 , 3 ]. To date, the effect of early ticagrelor administration versus treatment at the time of PCI has not been well studied. The ATLANTIC study demonstrated that prehospital administration of ticagrelor did not improve pre-PCI coronary reperfusion compared to in-hospital treatment [ 4 ]. We aimed to ...

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    10. Early versus delayed treatment with ticagrelor on residual thrombus after percutaneous coronary intervention in patients presenting with non-ST-elevation acute coronary syndrome an optical coherence tomography study

      Early versus delayed treatment with ticagrelor on residual thrombus after percutaneous coronary intervention in patients presenting with non-ST-elevation acute coronary syndrome an optical coherence tomography study

      Objective The level of inhibition of platelet aggregation immediately before percutaneous coronary intervention (PCI) is known to be related to early periprocedural outcomes. Ticagrelor is a reversible P2Y12 inhibitor that provides faster and more effective platelet inhibition compared to clopidogrel. This study sought to compare the antiplatelet effect on residual thrombus between early vs. delayed administration of ticagrelor following PCI in patients presenting with non-ST-elevation acute coronary syndromes (NSTE-ACS). Methods and Results Patients presenting with NSTE-ACS were screened in eight Korean centers, and randomized to receive ticagrelor either on presentation (early treatment) or immediately before PCI (delayed treatment). The primary ...

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    11. Characteristics of non-culprit plaques in acute coronary syndrome patients with layered culprit plaque

      Characteristics of non-culprit plaques in acute coronary syndrome patients with layered culprit plaque

      Aims  Layered plaques represent signs of previous plaque destabilization. A recent study showed that acute coronary syndrome (ACS) patients with layered culprit plaque have more vulnerability at the culprit lesion and systemic inflammation. We aimed to compare the characteristics of non-culprit plaques between patients with or without layered plaque at the culprit lesion. We also evaluated the characteristics of layered non-culprit plaques, irrespective of culprit plaque phenotype. Methods and results We studied ACS patients who had undergone pre-intervention optical coherence tomography (OCT) imaging. The number of non-culprit lesions was evaluated on coronary angiogram and morphological characteristics of plaques were studied ...

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    12. Cardiovascular OCT Imaging - Second Edition (Textbook)

      Cardiovascular OCT Imaging - Second Edition (Textbook)

      This heavily revised second edition comprehensively reviews the use of optical coherence tomography (OCT) in cardiovascular practice. It provides detailed guidance on how to properly interpret OCT images and successfully utilise it in daily clinical practice Chapters cover the development and physics associated with OCT, relevant interpretation skills, OCT imaging artifacts, plaque erosion, bioabsorbable stent, the detection of vulnerable plaque, and the use of OCT imaging in unison with other modalities such as phase contrast imaging (PCI). Areas of potential future development are also covered Cardiovascular OCT Imaging enables interventional cardiologists and cardiologists to quickly become both familiar and develop ...

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    13. Healed Culprit Plaques in Patients With Acute Coronary Syndrome

      Healed Culprit Plaques in Patients With Acute Coronary Syndrome

      ackground Healed plaques, morphologically characterized by a layered phenotype, are frequently found in subjects with sudden cardiac death. However, in vivo data are lacking. Objectives The purpose of this study was to determine the prevalence, morphological characteristics, and clinical significance of healed culprit plaques in patients with acute coronary syndromes (ACS) using optical coherence tomography (OCT). Methods A total of 376 ACS patients (252 ST-segment elevation myocardial infarction [MI] and 124 non–ST-segment elevation acute coronary syndrome) who had undergone pre-intervention OCT imaging of the culprit lesion were enrolled. Patients were stratified according to the presence of layered phenotype, defined ...

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    14. Angiographic features of patients with coronary plaque erosion

      Angiographic features of patients with coronary plaque erosion

      Background Although an in vivo diagnosis of coronary plaque erosion has become possible by optical coherence tomography (OCT), angiographic characteristics of erosion have not been studied. The aim of this study was to investigate the angiographic features of plaque erosion in patients with non-ST elevation acute coronary syndromes (NSTE-ACS). Methods Patients with NSTE-ACS who underwent OCT of the culprit lesion were collected at 11 institutions from 6 countries. Patients were classified as erosion or non-erosion based on OCT images. Angiographic features of both groups were compared. Results Among 494 cases with NSTE-ACS, 242 had plaque erosion and 252 had non-erosion ...

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    15. Coronary Atherosclerotic Phenotype and Plaque Healing in Patients With Recurrent Acute Coronary Syndromes Compared With Patients With Long-term Clinical Stability An In Vivo Optical Coherence Tomography Study

      Coronary Atherosclerotic Phenotype and Plaque Healing in Patients With Recurrent Acute Coronary Syndromes Compared With Patients With Long-term Clinical Stability An In Vivo Optical Coherence Tomography Study

      Importance At one end of the coronary artery disease (CAD) spectrum, there are patients with multiple recurrent acute coronary syndromes (rACS), and at the other end there are those with long-standing clinical stability. Predicting the natural history of these patients is challenging because unstable plaques often heal without resulting in ACS. Objective To assess in vivo the coronary atherosclerotic phenotype as well as the prevalence and characteristics of healed coronary plaques by optical coherence tomography (OCT) imaging in patients at the extremes of the CAD spectrum. Design, Setting, and Participants This is an observational, single-center cohort study with prospective clinical ...

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    16. Differences in coronary plaque morphology between East Asian and Western White patients: an optical coherence tomography study

      Differences in coronary plaque morphology between East Asian and Western White patients: an optical coherence tomography study

      Aims Prevalence of coronary artery disease as well as cardiac mortality varies between Asian and White patients. However, the link between race and plaque characteristics in patients with coronary artery disease remains largely unexplored. Thus, we aimed to investigate the detailed culprit plaque characteristics between East Asian and White patients using optical coherence tomography . Patients and methods A total of 101 East Asians were matched to 101 White patients. Matching parameters included age, sex, clinical presentation, hyperlipidemia, diabetes mellitus, and lesion location. Results There were no differences in underlying pathology (rupture vs. erosion) of acute coronary syndrome ( P =0.935 ...

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    17. Nonculprit Plaque Characteristics in Patients With Acute Coronary Syndrome Caused by Plaque Erosion vs Plaque Rupture A 3-Vessel Optical Coherence Tomography Study

      Nonculprit Plaque Characteristics in Patients With Acute Coronary Syndrome Caused by Plaque Erosion vs Plaque Rupture A 3-Vessel Optical Coherence Tomography Study

      Importance Patients with culprit plaque rupture are known to have pancoronary plaque vulnerability. However, the characteristics of nonculprit plaques in patients with acute coronary syndromes caused by plaque erosion are unknown. Objective To investigate the nonculprit plaque phenotype in patients with acute coronary syndrome according to culprit plaque pathology (erosion vs rupture) by 3-vessel optical coherence tomography imaging. Design, Setting, and Participants In this observational cohort study, between August 2010 and May 2014, 82 patients with ACS who underwent preintervention optical coherence tomography imaging of all 3 major epicardial coronary arteries were enrolled at the Massachusetts General Hospital Optical Coherence ...

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    18. 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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    19. Plaque Progression: Slow Linear or Rapid Stepwise?

      Plaque Progression: Slow Linear or Rapid Stepwise?

      Atherosclerosis was thought to be a disease of insidious onset and slow process, secondary to smooth muscle cell proliferation. 1 However, this concept was challenged during the past 2 decades by the theory that an alternative mode of rapid step-wise plaque progression might also exist. This sudden change in arterial lumen occurs when mural thrombus is organized after disruption of a plaque or by sudden expansion of a plaque secondary to intraplaque hemorrhage. Because of the sudden change in local geometry, this second mode is significant not only to rapid plaque progression, but also to the development of acute coronary ...

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    20. Low Endothelial Shear Stress Predicts Evolution to High-Risk Coronary Plaque Phenotype in the Future A Serial Optical Coherence Tomography and Computational Fluid Dynamics Stud

      Low Endothelial Shear Stress Predicts Evolution to High-Risk Coronary Plaque Phenotype in the Future A Serial Optical Coherence Tomography and Computational Fluid Dynamics Stud

      Background— Low endothelial shear stress (ESS) is associated with plaque progression and vulnerability. To date, changes in plaque phenotype over time in relation to ESS have not been studied in humans. The aim of this study was to investigate whether local ESS can predict subsequent changes to plaque phenotype using optical coherence tomography. Methods and Results— A total of 25 coronary arteries from 20 patients who underwent baseline and 6-month follow-up optical coherence tomography were included. Arteries were divided into serial 3-mm segments, and plaque characteristics were evaluated in each segment. A total of 145 segments were divided into low-ESS ...

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    21. Differences in coronary plaque characteristics between patients with and those without peripheral arterial disease

      Differences in coronary plaque characteristics between patients with and those without peripheral arterial disease

      Introduction: Cardiovascular mortality of patients with combined peripheral arterial disease (PAD) and coronary artery disease (CAD) is twice as high as that in those with either disease alone. It is known that patients with PAD undergoing percutaneous coronary intervention have a higher incidence of adverse cardiac events such as myocardial infarction or target vessel revascularization. Objective: In this study, we compared the detailed characteristics of culprit and nonculprit plaques between patients with and those without PAD using optical coherence tomography. Patients and methods: We performed propensity score matching using the following variables: (i) age; (ii) sex; (iii) clinical presentation; (iv ...

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    1. (124 articles) Massachusetts General Hospital
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