Key result
Lower peripheral endothelial function was independently associated with thin-cap fibroatheroma in acute coronary syndromes (OR per 0.1 increase in Ln_RHI 0.78; 95% CI 0.62-0.98; P=0.03).
Why the study?
Thinning of the fibrous cap indicates plaque vulnerability, and endothelial dysfunction is linked to inflammation and matrix metalloproteinases, but the association between endothelial dysfunction and OCT-derived TCFA in ACS was unclear.
Observational (n=89)
Odds Ratio: 0.78 (95% CI 0.62–0.98)
p-value: p=0.03
Peripheral endothelial dysfunction is independently associated with plaque vulnerability, specifically thin-cap fibroatheroma, in patients with acute coronary syndromes.
May identify higher-risk ACS patients with vulnerable plaques; leaves open whether endothelial testing improves risk stratification or outcomes.
Background: Thinning of the fibrous cap of atherosclerotic plaque is a major component of plaque vulnerability. The high resolution of optical coherence tomography (OCT) provides an accurate measurement of fibrous-cap thickness. Endothelial dysfunction is associated with inflammation and enhanced local expression of matrix metalloproteinases. We investigated the association between endothelial dysfunction and OCT-derived thin-cap fibroatheroma (TCFA) in patients with acute coronary syndromes (ACS). Methods: Seventy-four patients with ACS, who underwent both OCT examinations of the culprit lesion before percutaneous coronary intervention and peripheral endothelial function assessment as assessed by logarithmic value of reactive hyperemia index (Ln_RHI), were enrolled. Age-, sex-, hypertension-, and diabetes-matched non-coronary artery disease (non-CAD) patients were also enrolled (n=15). Results: Ln_RHI levels were significantly lower in ACS patients compared with non-CAD patients (0.56±0.26 vs 0.74±0.22, P =0.01). Furthermore, the Ln_RHIs of ACS patients with TCFA (n=44) were significantly lower than those of ACS patients without TCFA (n=30) (0.50±0.24 vs 0.65±0.26, P =0.01). There was a weak but significant positive correlation between Ln_RHI and fibrous-cap thickness (Spearman’s ρ =0.25, P =0.03). Multivariate logistic regression analysis identified lower Ln_RHI as an independent factor associated with TCFA in ACS patients (OR per 0.1 increase in Ln_RHI: 0.78 [95% CI: 0.62–0.98], P =0.03). Conclusion: Advanced endothelial dysfunction significantly correlates with a thin fibrous cap of coronary plaques in patients with ACS.
No takes yet. Share an insight, caveat, or question.
Matsuzawa et al. (2019) conducted an observational in Acute coronary syndromes (n=89). Peripheral endothelial function (Ln_RHI) vs. Higher Ln_RHI was evaluated on Presence of thin-cap fibroatheroma (TCFA) (OR 0.78, 95% CI 0.62-0.98, p=0.03). Lower peripheral endothelial function was independently associated with thin-cap fibroatheroma in acute coronary syndromes (OR per 0.1 increase in Ln_RHI 0.78; 95% CI 0.62-0.98; P=0.03).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: