What does this research mean for the field?

In acute coronary syndromes, high angiographic thrombus burden is associated with OCT-defined vulnerable plaque morphology and independently predicts long-term major adverse cardiac events following percutaneous coronary intervention. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To determine the prognostic relevance of angiographic thrombus burden and its association with optical coherence tomography-defined plaque vulnerability in patients with acute coronary syndromes.

August 22, 2026Journal of the American Heart AssociationOpen Access

Optical Coherence Tomography‐Defined Vulnerable Plaques and Intracoronary Thrombus in Acute Coronary Syndromes: Insights From the OPTICO‐ACS Program

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Authors

GPGiuseppe Panuccio SRSalvatore De Rosa EAElaaha Anwari

Discussion

Member takes

Overview

Clinical trial demonstrates that high thrombus burden predicts major adverse cardiac events in acute coronary syndromes, indicating thrombus reflects active plaque vulnerability.

Key Points

To determine the prognostic relevance of angiographic thrombus burden and its association with optical coherence tomography-defined plaque vulnerability in patients with acute coronary syndromes.
Prospective, multicenter trial (NCT03129503) analyzing 300 patients with acute coronary syndromes undergoing percutaneous coronary intervention, followed for a median of 12 months.
Culprit lesion morphology was characterized via optical coherence tomography, defining plaque vulnerability by >2 high-risk features (thin-cap fibroatheroma, lipid arc >180°, microcalcifications, macrophage infiltration).
Vulnerable plaque morphology was significantly more prevalent in high vs. low thrombus burden (89.0% vs 75.3%, P=0.002) and was independently associated with high thrombus burden (adjusted OR 2.5, 95% CI, 1.31–4.89, P=0.005).
High thrombus burden significantly increased short-term (12.3% vs 1.4%, P<0.001) and long-term (22.1% vs 13.7%, P=0.04) major adverse cardiac events, serving as an independent long-term predictor (adjusted HR 2.2, 95% CI, 1.23–3.98, P=0.008).

Cite This Study

Panuccio et al. (2026) studied this question.

synapsesocial.com/papers/6a895fd3ca7ade938187eb23 https://doi.org/10.1161/jaha.125.047485

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August 22, 2026Journal of the American Heart AssociationOpen Access

Optical Coherence Tomography‐Defined Vulnerable Plaques and Intracoronary Thrombus in Acute Coronary Syndromes: Insights From the OPTICO‐ACS Program

View Full Paper

Ask AI

Bookmark

Authors

GPGiuseppe Panuccio SRSalvatore De Rosa EAElaaha Anwari

Discussion

Member takes

Overview

Clinical trial demonstrates that high thrombus burden predicts major adverse cardiac events in acute coronary syndromes, indicating thrombus reflects active plaque vulnerability.

Key Points

To determine the prognostic relevance of angiographic thrombus burden and its association with optical coherence tomography-defined plaque vulnerability in patients with acute coronary syndromes.
Prospective, multicenter trial (NCT03129503) analyzing 300 patients with acute coronary syndromes undergoing percutaneous coronary intervention, followed for a median of 12 months.
Culprit lesion morphology was characterized via optical coherence tomography, defining plaque vulnerability by >2 high-risk features (thin-cap fibroatheroma, lipid arc >180°, microcalcifications, macrophage infiltration).
Vulnerable plaque morphology was significantly more prevalent in high vs. low thrombus burden (89.0% vs 75.3%, P=0.002) and was independently associated with high thrombus burden (adjusted OR 2.5, 95% CI, 1.31–4.89, P=0.005).
High thrombus burden significantly increased short-term (12.3% vs 1.4%, P<0.001) and long-term (22.1% vs 13.7%, P=0.04) major adverse cardiac events, serving as an independent long-term predictor (adjusted HR 2.2, 95% CI, 1.23–3.98, P=0.008).

Cite This Study

Panuccio et al. (2026) studied this question.

synapsesocial.com/papers/6a895fd3ca7ade938187eb23 https://doi.org/10.1161/jaha.125.047485

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