Degree of luminal narrowing and composition of thrombus in plaque erosion.
As the degree of luminal narrowing increases, shear stress increases, and high shear stress is known to activate platelets. However, the relationship between the degree of luminal narrowing and the composition of thrombus in patients with plaque erosion has not been studied. A total of 148 patients with plaque erosion and thrombus detected by optical coherence tomography were divided into tertiles based on the minimum lumen area (MLA) at the culprit lesion. Thrombus was categorized as platelet-rich or fibrin-rich. Among 148 patients, 50 (34%) were in the mild stenosis group, 49 (33%) were in the moderate stenosis group, and 49 (33%) were in the severe stenosis group. The composition of thrombus was significantly different among the 3 groups (prevalence of platelet-rich thrombus was 60% in the mild stenosis group; 78% in the moderate stenosis group; and 84% in the severe stenosis group; P = 0.021). The pattern of fibrin-rich thrombus showed the opposite: 40%, 22%, and 16%, respectively. In the multivariate analysis, current smoking was independently associated with fibrin-rich thrombus (odds ratio [OR] 2.364 [95% CI 1.004-5.567], P = 0.049). This study demonstrated that platelet-rich thrombus was the predominant type of thrombus in plaque erosion. The prevalence of fibrin-rich thrombus was highest in the mild stenosis group.
['Kurihara|Osamu|O|', 'Takano|Masamichi|M|', 'Soeda|Tsunenari|T|', 'Fracassi|Francesco|F|', 'Araki|Makoto|M|', 'Nakajima|Akihiro|A|', 'McNulty|Iris|I|', 'Lee|Hang|H|', 'Mizuno|Kyoichi|K|', 'Jang|Ik-Kyung|IK|']
D000328:Adult D000368:Aged D001792:Blood Platelets D003251:Constriction, Pathologic D017023:Coronary Angiography D003328:Coronary Thrombosis D003331:Coronary Vessels D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D058226:Plaque, Atherosclerotic D053657:Platelet-Rich Plasma
Plaque erosion Optical coherence tomography Platelet-rich thrombus Fibrin-rich thrombus