Sites of coronary plaque rupture demonstrated a significantly greater macrophage density than non-ruptured sites (6.95% vs 5.29%; p=0.002).
Observational
Does macrophage density measured by intracoronary OCT correlate with clinical presentation in patients with coronary artery disease?
Intracoronary OCT demonstrates that increased focal and multi-focal plaque macrophage densities strongly correlate with acute coronary syndrome severity and plaque rupture.
Absolute Event Rate: 6.95% vs 5.29%
p-value: p=0.002
OBJECTIVES: This study was designed to utilize optical coherence tomography (OCT) images of coronary atherosclerotic plaque macrophages to investigate the relationship between macrophage distributions and clinical syndrome. BACKGROUND: The relative significance of focal macrophage infiltration and generalized coronary inflammation for predicting acute coronary events is a currently a source of considerable controversy in cardiology. Lack of a high-resolution cross-sectional imaging modality has limited macrophage evaluation in vivo. METHODS: Intracoronary OCT imaging was performed at culprit and non-culprit plaques in patients presenting with stable angina pectoris, unstable angina pectoris,and ST-segment elevation myocardial infarction. Macrophage densities were quantified from these images and analyzed with respect to the clinical presentations of the patients under investigation. RESULTS: A significantly greater macrophage density was found in unstable patients, both for fibrous and lipid-rich plaques (p = 0.025 and p = 0.002, respectively). Within each patient, the macrophage densities at culprit and non-culprit lesions correlated significantly (r = 0.66, y = 0.88x + 0.43, p = 0.01). Sites of plaque rupture demonstrated a greater macrophage density than non-ruptured sites (6.95 +/- 1.60%, 5.29 +/- 1.17%; p = 0.002). Surface macrophage infiltration was a stronger predictor of unstable clinical presentation than subsurface infiltration for culprit lesions (p = 0.035) but not for remote lesions (p = 0.80). CONCLUSIONS: Our results demonstrate that increases in both multi-focal and focal macrophage densities are highly correlated with symptom severity. By providing a means of detecting increases in plaque macrophage content before an acute event, this technique may aid in determining prognosis and guiding preventive therapy.
MacNeill et al. (2004) conducted an observational in Coronary artery disease. Plaque rupture vs. Non-ruptured sites was evaluated on Macrophage density (p=0.002). Sites of coronary plaque rupture demonstrated a significantly greater macrophage density than non-ruptured sites (6.95% vs 5.29%; p=0.002).