Effects of Fatty Acid Therapy in Addition to Strong Statin on Coronary Plaques in Acute Coronary Syndrome: An Optical Coherence Tomography Study

Figures

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  Figure 1. Study profile. ACS indicates acute coronary syndrome; CAG, coronary angiography; DHA, docosahexaenoic acid; EPA, eicosapentaenoic acid; OCT, optical coherence tomography; and PCI, percutaneous coronary intervention.

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  Figure 2. Representative cases of optical coherence tomography analysis. A, In a case from the control group, fibrous cap thickness slightly increased (130–150 μm) and lipid arc changed very slightly (134.9–145.0°) over 8 months. B, In a case from the EPA group, fibrous cap thickness increased (60–210 μm) and lipid arc decreased (118.3 to 95.1°) over 8 months. C, In a case from the EPA+DHA group, fibrous cap thickness increased (60–150 μm) and lipid arc decreased slightly (158.7 to 145.3°) over 8 months. DHA indicates docosahexaenoic acid; and EPA, eicosapentaenoic acid.

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  Figure 3. Correlations between the percent change for minimum FCT and minimum FCT at baseline . A, No correlation was found in the control group (r=−0.2718, P=0.1392). B, A significant negative correlation was found in the EPA group (r=−0.5368, P=0.0018). C, A significant negative correlation was found in the EPA+DHA group (r=−0.5193, P=0.0014). DHA indicates docosahexaenoic acid; EPA, eicosapentaenoic acid; and FCT, fibrous cap thickenss.

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  Figure 4. Comparison of the percent change for minimum FCT at the 8‐month follow‐up relative to baseline in the control, EPA, and EPA+DHA groups in subgroup analysis. A, In patients with minimum FCT <120 µm, percent change for FCT was significantly lower in the control group (33.3; interquartile interval, 5.0–80.0) compared with the EPA group (110; interquartile interval, 64.3–145.6; P=0.0230 vs control) or the EPA+DHA group (125; interquartile interval, 100.0–300.0; P=0.0140 vs control). B, In patients with minimum FCT ≥120 µm, there were no significant differences between the control group (14.2; interquartile interval, −6.0 to 57.5) and the EPA group (5.6; interquartile interval, −13.0 to 15.5; P=0.768 vs control) or the EPA+DHA group (10.9; interquartile interval, 1.8–10.9, P=0.990 vs control). C, In patients with TCFA, percent change for minimum FCT was significantly higher in the EPA group (120.0; interquartile interval, 83.3–366.7; P=0.0185 vs control) or the EPA+DHA group (160; interquartile interval, 108.3–391.7; P=0.0240 vs control) compared with the control group (15.0; interquartile interval, 0–50.0). DHA indicates docosahexaenoic acid; EPA; eicosapentaenoic acid; FCT, fibrous…