1. Articles from Sining Hu

    1-24 of 34 1 2 »
    1. Relationship between elevated plasma ceramides and plaque rupture in patients with ST-segment elevation myocardial infarction

      Relationship between elevated plasma ceramides and plaque rupture in patients with ST-segment elevation myocardial infarction

      Background and aims Ceramides (Cer) is an atherogenic substance. However, the associations between specific plasma Cer levels and culprit plaque morphology in ST-segment elevation myocardial infarction (STEMI) patients are unclear. Methods The study consisted of two parallel cohorts. 100 consecutive patients with STEMI were screened as discovery cohort. In the validation cohort, we separately screened 30 normal donors, 30 stable angina pectoris (SAP) and 315 STEMI patients. All STEMI patients underwent emergency percutaneous intervention (PCI) and optical coherence tomography (OCT) examination for culprit plaque. Based on established diagnostic criteria, STEMI patients were classified into plaque rupture (PR) and plaque erosion ...

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      Mentions: Bo Yu
    2. 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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    3. Non-culprit plaque characteristics in acute coronary syndrome patients with raised hemoglobinA1c: an intravascular optical coherence tomography study

      Non-culprit plaque characteristics in acute coronary syndrome patients with raised hemoglobinA1c: an intravascular optical coherence tomography study

      Background Raised hemoglobinA1c (HbA1c) is an indicator of pre-diabetes, which is associated with increased risk of coronary artery disease. However, the detailed morphological characteristics of non-culprit plaques in acute coronary syndrome (ACS) patients remain largely unknown. Methods A total of 305 non-culprit plaques from 216 ACS patients were analyzed by intravascular optical coherence tomography. These patients were divided into three groups according to the serum glycosylated hemoglobin level: normal HbA1c (< 5.7%), pre-diabetes with raised HbA1c (5.7–6.4%) and diabetes mellitus (DM). Results Plaques in patients with raised HbA1c had a longer lipid length (17.0 ± 8.3 ...

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    4. 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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    5. 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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    6. 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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    7. Role of Optical Coherence Tomography in Diagnosis and Treatment of Patients with Acute Coronary Syndrome

      Role of Optical Coherence Tomography in Diagnosis and Treatment of Patients with Acute Coronary Syndrome

      Acute coronary syndrome (ACS) is the main cause of death worldwide and the leading cause of disease burden in high-income countries. ACS refers to a constellation of clinical symptoms that are compatible with acute myocardial ischemia. It describes a spectrum of clinical manifestations that result from a common pathophysiological process. The most common cause of ACS are rupture of an atherosclerotic lesion containing a large necrotic core and a thin fibrous cap followed by acute luminal thrombosis. It was thought that a high-resolution imaging modality would be ideal to detect high-risk plaques before their disruption and the formation of an ...

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    8. 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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    9. 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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    10. 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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    11. 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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    12. 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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    13. 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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    14. 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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    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. Impacts of lesion angle on incidence and distribution of acute vessel wall injuries and strut malapposition after drug-eluting stent implantation assessed by optical coherence tomography

      Impacts of lesion angle on incidence and distribution of acute vessel wall injuries and strut malapposition after drug-eluting stent implantation assessed by optical coherence tomography

      Aims To investigate the impact of lesion angle on the incidence and distribution of acute vessel wall injuries and incomplete stent apposition (ISA) following second-generation drug-eluting stent (DES) implantation using optical coherence tomography (OCT). Several ex vivo studies demonstrated that angled arterial walls are exposed to imbalanced mechanical stress from deployed stents. Methods and results We included 243 lesions treated with a single DES (148 everolimus-eluting stent and 95 zotarolimus-eluting stent). Angled lesions were defined as lesions with angle ≥45° on an angiogram ( n = 58). The vessel wall injuries and ISA were evaluated by OCT. The results were compared with ...

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    17. Insights into the spatial distribution of lipid-rich plaques in relation to coronary artery bifurcations: an in-vivo optical coherence tomography study

      Insights into the spatial distribution of lipid-rich plaques in relation to coronary artery bifurcations: an in-vivo optical coherence tomography study

      Objectives: The aim of this study was to investigate the spatial location of vulnerable plaques at coronary artery bifurcations using frequency domain-optical coherence tomography. Background: In-vivo data on geometric location of vulnerable plaques in relation to coronary bifurcation are limited. Materials and methods: A total of 40 patients with left anterior descending artery bifurcation were studied. Plaque characteristics in five regions in relation to a side branch were compared: opposite flow divider (OFD); bifurcation site (BF); main branch side proximal (MBP); side branch side proximal (SBP); and flow divider (FD). Frequency domain-optical coherence tomography was used for plaque characterization. Results ...

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    18. Bivalirudin versus unfractionated heparin for residual thrombus burden: A frequency-domain optical coherence tomography study

      Bivalirudin versus unfractionated heparin for residual thrombus burden: A frequency-domain optical coherence tomography study

      Objectives: This study aimed to compare the effect of bivalirudin and unfractionated heparin (UFH) on residual thrombus burden assessed by frequency-domain optical coherence tomography (FD-OCT), and on angiographic indices of microvascular obstruction (MVO). Background: The efficacy of bivalirudin to inhibit thrombus formation inside the stent during percutaneous coronary interventions (PCI) as compared to UFH is unknown. Methods: Sixty patients with coronary artery disease who underwent post-PCI FD-OCT were studied, including 20 patients treated with bivalirudin and 40 control patients treated with UFH, matched by clinical presentation, stent characteristics, and periprocedural medications. In-stent thrombus volume, thrombus score (number of quadrants with ...

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    19. Prevalence and Characteristics of TCFA and Degree of Coronary Artery Stenosis An OCT, IVUS, and Angiographic Study

      Prevalence and Characteristics of TCFA and Degree of Coronary Artery Stenosis An OCT, IVUS, and Angiographic Study

      Background The relationship between features of vulnerable plaque and angiographic coronary stenosis is unknown. Objectives The purpose of this study was to systematically investigate the absolute number, relative prevalence, and characteristics of thin-cap fibroatheroma (TCFA) at different degrees of stenosis using optical coherence tomography (OCT), intravascular ultrasound, and coronary angiography. Methods We identified 643 plaques from 255 subjects who underwent OCT imaging in all 3 coronary arteries. They were divided into 3 groups on the basis of angiographic diameter stenosis: Group A (30% to 49%, n = 325), Group B (50% to 69%, n = 227), and Group C (>70%, n = 91 ...

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    20. Comparison by Optical Coherence Tomography of the Frequency of Lipid Coronary Plaques in Current Smokers, Former Smokers, and Non-smokers

      Comparison by Optical Coherence Tomography of the Frequency of Lipid Coronary Plaques in Current Smokers, Former Smokers, and Non-smokers

      Smoking is associated with high incidence of cardiovascular events including acute coronary syndrome (ACS). We sought to characterize coronary plaques in patients with ongoing smoking using optical coherence tomography (OCT) compared to former smokers and nonsmokers. We identified 465 coronary plaques from 182 subjects who underwent OCT imaging for all three coronary arteries. Subjects were divided into 3 groups: current smokers (n=41), former smokers (n=67) and nonsmokers (n=74). OCT analysis included the presence of lipid rich plaque, thin-cap fibroatheroma (TCFA), calcification, maximum lipid arc, lipid core length, lipid index, and fibrous cap thickness (FCT). Lipid index was ...

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    21. Spatial Heterogeneity of Neoatherosclerosis, and its Relationship with Neovascularization and Adjacent Plaque Characteristics: Optical Coherence Tomography Study

      Spatial Heterogeneity of Neoatherosclerosis, and its Relationship with Neovascularization and Adjacent Plaque Characteristics: Optical Coherence Tomography Study

      Background Development of neoatherosclerosis (NA) has been reported to be a potential cause of late stent failure. However, the distribution of NA and its relationship with neovascularization (NV) and adjacent plaque characteristics remain unclear. Methods We investigated 167 stents (40 bare-metal stents, 84 sirolimus-eluting stents, and 43 everolimus-eluting stents) with optical coherence tomography. Each stent was divided into the proximal section (PS), mid section (MS) and distal section (DS). NA was defined as lipid-laden neointima or calcification inside stent. Adjacent plaque characteristics were evaluated within 5 mm proximal and distal reference segments. Results NA was more frequent in PS and ...

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    22. Distinct Morphological Features of Ruptured Culprit Plaque for Acute Coronary Events Compared to those with Silent Rupture and Thin-Cap Fibroatheroma: a Combined Optical Coherence Tomography and Intravascular Ultrasound Study

      Distinct Morphological Features of Ruptured Culprit Plaque for Acute Coronary Events Compared to those with Silent Rupture and Thin-Cap Fibroatheroma: a Combined Optical Coherence Tomography and Intravascular Ultrasound Study

      Objectives To identify specific morphological characteristics of ruptured culprit plaques (RCP) responsible for acute events, and compare them with ruptured non-culprit plaques (RNCP) and non-ruptured thin-cap fibroatheroma (TCFA) in patients presenting with acute coronary syndromes (ACS). Background Non-ruptured TCFA and multiple ruptured plaques are detected in the same patients with ACS. It remains unknown whether certain morphological characteristics determine rupture of TCFA and subsequently result in ACS. Methods We analyzed 126 plaques (RCP=49, RNCP=19, TCFA=58) from 82 ACS patients using optical coherence tomography (OCT) and intravascular ultrasound (IVUS). Fibrous cap thickness was determined by OCT. Plaque burden ...

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