Key result
The overall incidence of healed plaques under OCT in patients with coronary artery disease was 40% (95% CI: 39-42), with higher rates in stable angina pectoris and culprit plaques.
Why the study?
The study was conducted to determine the prevalence of healed plaque and its characteristics under OCT in patients with coronary artery disease.
Meta-Analysis
Healed plaques are highly prevalent (40%) in CAD patients undergoing OCT, particularly in stable angina and culprit lesions, and are associated with higher rates of vulnerable plaque characteristics.
Healed plaques warrant inclusion in OCT phenotyping; extends atherosclerosis characterization but leaves prognostic and therapeutic implications open.
Aim: The purpose of this study was to determine the prevalence of healed plaque and its characteristics under optical coherence tomography (OCT) through a formal systematic review, meta-analysis, and meta-regression. Methods and Results: Thirteen studies were selected from MEDLINE, EMBASE, Cochrane, and online databases. The overall incidence of healed plaques was 40% (95% CI: 39–42), with 37% (95% CI: 35–39) in patients with acute coronary syndrome (ACS) and with 46% (95% CI: 43–49) in patients with stable angina pectoris (SAP). The incidence of healed plaque among culprit plaques (48%, 95% CI: 46–50) was nearly two times higher than that among non-culprit plaques (24%, 95% CI: 21–27). The incidence of thin cap fibroatheroma (TCFA), plaque rupture, microvessel, macrophage accumulation, and calcification was significantly higher in the healed plaque group. Meta-regression revealed an association between smoking (P = 0.033) and healed plaque rupture. Gender (P = 0.047) was independently associated with macrophage accumulation, and mean low-density lipoprotein cholesterol (LDL-C) was independently associated with microvessel. Conclusions: In summary, with a total incidence of 40%, the incidence of healed plaques under OCT was higher in SAP than in ACS, and higher in culprit plaques than in non-culprit plaques. Higher incidence of TCFA, plaque rupture, microvessel, macrophage accumulation, and calcification was found in the healed-plaque group. Smoking, gender, and mean LDL-C level were associated with healed-plaque characteristics.
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Feng et al. (2021) conducted a meta-analysis in Coronary Artery Disease. Healed plaque was evaluated on Overall incidence of healed plaques (95% CI 39-42). The overall incidence of healed plaques under OCT in patients with coronary artery disease was 40% (95% CI: 39-42), with higher rates in stable angina pectoris and culprit plaques.
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