Clinical Course of Optical Coherence Tomography-Detected Lipid-Rich Coronary Plaque After Optimal Medical Therapy

• Material Type: 博士論文
• Title: Clinical Course of Optical Coherence Tomography-Detected Lipid-Rich Coronary Plaque After Optimal Medical Therapy
• Author/Editor: Sugiura, Junichi; Soeda, Tsunenari; Kyodo, Atsushi; Nakamura, Takuya; Okamura, Akihiko; Nogi, Kazutaka; Hashimoto, Yukihiro; Ueda, Tomoya; Watanabe, Makoto; Saito, Yoshihiko
• Author Heading: Sugiura, Junichi; Soeda, Tsunenari; Kyodo, Atsushi; Nakamura, Takuya; Okamura, Akihiko; Nogi, Kazutaka; Hashimoto, Yukihiro; Ueda, Tomoya; Watanabe, Makoto; Saito, Yoshihiko
• Publication, Distribution, etc.: Japanese Circulation Society
• Publication Date: 2021-12-03
• Publication Date (W3CDTF): 2021-12-03
• Alternative Title: OCT で検出された冠動脈のlipid-richプラークに対する至適薬物療法施行後の臨床経過
• Periodical title: Circulation reports
• No. or year of volume/issue: 4 1
• Volume: 4
• Issue: 1
• Pages: 29-37
• ISSN (Periodical Title): ISSN : 2434-0790
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2023-03-15
• Dissertation Number: 甲第869号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: Coronary computed tomography; High-risk plaque feature; Lipid rich coronary plaque; Optical coherence tomography; Optimal medical therapy
• Target Audience: 一般
• Note (General): type:Thesis; Background: The aim of this study was to evaluate optical coherence tomography (OCT)-detected lipid-rich coronary plaques (LRCPs) with coronary computed tomography angiography (CCTA) 10 months after optimal medical therapy (OMT). Methods and Results: Baseline OCT detected 28 LRCPs in non-culprit lesions. High-risk plaque features (HRPFs), such as positive remodeling, very low attenuation plaques, napkin-ring sign, and spotty calcification, were observed in 67.9%, 67.9%, 21.4%, and 64.3% of LRCPs, respectively, at the 10-month follow-up CCTA. Lesions with ≥3 HRPFs were defined as high-risk LRCPs (n=12); the remaining were defined as low-risk LRCPs (n=16). The maximum lipid arc on baseline OCT was larger in high- than low-risk LRCPs (221±62° vs. 179±44°, respectively; P=0.04). Receiver operating characteristic curve analysis indicated that a maximum lipid arc >154° on baseline OCT was the optimal cut-off value to predict high-risk LRCPs 10 months after OMT. Patients with high-risk LRCPs had worse clinical outcomes, defined as a composite of cardiac death, target lesion-related myocardial infarction, and target lesion-related revascularization, during follow-up than those with low-risk LRCPs (33.3% vs. 0%; P=0.01). Conclusions: A high-risk LRCP at follow-up CCTA was correlated with a larger maximum lipid arc on baseline OCT. Further aggressive treatment for patients with large LRCPs may reduce vulnerable plaque features and prevent future cardiac events.; 博士（医学）・甲第869号・令和5年3月15日; © 2022, THE JAPANESE CIRCULATION SOCIETY This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.; identifier:Circulation reports Vol.4 No.1 p.29-37 (2021 Dec); identifier:24340790; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/4101; identifier:Circulation reports, 4(1): 29-37
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.1253/circrep.CR-21-0147
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

Table of Contents

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/4101/1/01%e7%94%b2869%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/4101/2/02%e7%94%b2869%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/4101/6/03%e7%94%b2869%e6%9c%ac%e6%96%87.pdf fulltext