Relationship between OCT-derived plaque characteristics, CTA-derived coronary inflammation, and CMR-derived global coronary flow reserve in patients with acute coronary syndrome

Abstract Background The presence of layered plaque is suggestive recurrent thrombotic events. However, the impact detected by optical coherence tomography (OCT) on coronary inflammation and flow reserve remains unclear. Purpose We aimed to investigate association OCT-derived with pericoronary adipose tissue assessed computed angiography (cCTA) global (G-CFR) cardiac magnetic resonance imaging (CMR) in patients acute syndrome (ACS). Methods investigated 88 first ACS who underwent preprocedural cCTA OCT culprit lesion, CMR after percutaneous intervention (PCI). All were divided into four groups according characteristics: vs. non-layered plaque; rupture erosion. Coronary was mean value (PCAT) attenuation (−190 −30 HU) three major vessels. G-CFR obtained quantifying absolute sinus at rest during maximum hyperemia. CCTA findings compared between groups. Results In a total patients, [L] [PR] observed 25 erosion [PE] 26 [NL] PR 23 PE 14 respectively. Three-vessel-PCAT (L-PR L-PE NL-PR NL-PE; −68.13±6.18 −69.01±6.72 −69.76±4.04 −74.61±5.63 HU, P=0.009) vessel PCAT −66.39±7.38 −68.94±8.06 −70.01±5.76 −75.45±6.60 P=0.003) showed graded difference also 2.26 [1.80–2.87] 2.24 [1.72–3.13] 2.97 [2.24–3.83] 3.18 [2.67–4.08], P=0.022). Conclusions lesion associated high PCATA low ACS. Detection may indicate increased impaired reserve, potentially providing risk stratification Funding Acknowledgement Type funding sources: None.