Key result
OCT-defined plaque erosion accounts for ~53% of STEMI cases and is linked to younger smokers.
Why the study?
Data on OCT-defined plaque characteristics in South Asian STEMI populations remain limited.
Do clinical and angiographic characteristics differ between STEMI patients with OCT-defined plaque erosion versus plaque rupture?
Cross-Sectional (n=30)
No
Do clinical and angiographic characteristics differ between STEMI patients with OCT-defined plaque erosion versus plaque rupture?
Absolute Event Rate: 53.3% vs 46.7%
OCT-defined plaque erosion and plaque rupture exhibit differing clinical profiles in STEMI patients, with erosion being more common among younger smokers.
A BSTRACT Background: Plaque rupture and plaque erosion are the key mechanisms underlying acute coronary syndromes. Optical coherence tomography (OCT) enables high-resolution in vivo assessment of culprit plaque morphology and has improved understanding of culprit plaque morphology. However, data on OCT-defined plaque characteristics in South Asian ST-segment elevation myocardial infarction (STEMI) populations remain limited. Objectives: The objective of this study is to compare the clinical and angiographic characteristics of STEMI patients with OCT-defined plaque erosion and plaque rupture. Materials and Methods: This cross-sectional study included 30 consecutive STEMI patients undergoing primary percutaneous coronary intervention with preintervention OCT imaging of the culprit lesion. Lesions were classified as plaque erosion or plaque rupture using the established OCT criteria. Demographic characteristics, cardiovascular risk factors, medication history, and angiographic variables were recorded and analyzed. Results: Plaque erosion was identified in 16 patients (53.3%) and plaque rupture in 14 patients (46.7%). Patients with plaque erosion tended to be younger and were more frequently smokers than those with plaque rupture. Prior statin use was numerically higher in the erosion group. The left anterior descending artery was the most common culprit vessel in both groups, followed by the right coronary artery and the left circumflex artery. OCT differentiated intact fibrous-cap lesions with overlying thrombus consistent with erosion from lesions showing fibrous-cap discontinuity and cavity formation consistent with rupture. Conclusion: OCT-defined plaque erosion and plaque rupture showed differing clinical profiles, with erosion more common among younger smokers. OCT provided additional mechanistic insight beyond angiography. Larger prospective studies are required to validate these findings and clarify their prognostic implications.
No takes yet. Share an insight, caveat, or question.
Imamuddin et al. (2026) conducted a cross-sectional in ST-segment elevation myocardial infarction (STEMI) (n=30). OCT-defined plaque erosion vs. OCT-defined plaque rupture was evaluated on Prevalence of plaque erosion vs plaque rupture. OCT-defined plaque erosion was identified in 53.3% of STEMI patients and plaque rupture in 46.7%, with erosion showing a differing clinical profile including being more common in younger smokers.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: