Objective::Microchannels are associated with the progression of atherosclerotic vulnerable plaques. However, in patients with culprit optical coherence tomography (OCT)-defined plaque erosion, the knowledge of microchannels and culprit lesion vulnerability is limited. The aim of this study was to investigate culprit lesion characteristics in patients with ST-segment elevated myocardial infarction (STEMI) caused by plaque erosion with and without microchannels using OCT.Methods::In all, 348 STEMI patients with plaque erosion who underwent OCT of the culprit lesion at the 2 nd Affiliated Hospital of Harbin Medical University (Harbin, China) from August 2014 to December 2017 were included and divided into the microchannel group ( n= 116, 33.3%) and no-microchannel group ( n = 232, 66.7%). The clinical characteristics and OCT-derived plaque features were compared between both groups. Results::Among the 348 STEMI patients with plaque erosion, culprit lesions with microchannels had higher incidence of lipid plaque (59.5% vs. 45.3%, P= 0.012); calcification (41.4% vs. 24.6%, P= 0.002); spotty calcification (30.2% vs. 18.1%, P= 0.014); macrophages accumulation (72.4% vs. 45.7%, P < 0.001); and cholesterol crystals (32.8% vs. 14.2%, P < 0.001) than those without microchannels. In addition, minimal lumen area was smaller ((1.9 ± 0.9) mm 2vs. (2.8 ± 2.3) mm 2, P < 0.001) and lumen area stenosis was greater ((71.3% ± 13.4%) vs. (65.3% ± 19.3%), P= 0.001) in the microchannel group than in the no-microchannel group. Conclusion::In patients with STEMI caused by plaque erosion, one-third manifested typical microchannel characteristics, and those with microchannels were associated with more severe luminal stenosis and more vulnerable plaque features than those without microchannels.

Optical coherence tomography;Microchannel;Plaque erosion

Jiang Senqing;Guo Junchen;Yin Yanwei;Fang Chao;Wang Jifei;Wang Yidan;Lei Fangmeng;Sun Sibo;Pei Xueying;Jia Ruyi;Zhang Shaotao;Li Lulu;Wang Yini;Xing Lei;Yu Huai;Liu Huimin;Xu Maoen;Ren Xuefeng;Ma Lijia;Wei Guo;Hou Jingbo;Dai Jiannan;Yu Bo

Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, Heilongjiang 150086, China

心血管病探索（英文）

[1]Jiang Senqing;Guo Junchen;Yin Yanwei;Fang Chao;Wang Jifei;Wang Yidan;Lei Fangmeng;Sun Sibo;Pei Xueying;Jia Ruyi;Zhang Shaotao;Li Lulu;Wang Yini;Xing Lei;Yu Huai;Liu Huimin;Xu Maoen;Ren Xuefeng;Ma Lijia;Wei Guo;Hou Jingbo;Dai Jiannan;Yu Bo-.Relationship of Microchannels and Plaque Erosion in Patients with ST-Segment Elevation Myocardial Infarction: An Optical Coherence Tomography Study)[J].心血管病探索（英文）,2022(02):83-88

Microchannels,spotty

Relationship,Plaque,Erosion,Patients,Segment,Elevation,Myocardial,Infarction,An,Optical,Coherence,Tomography,Study,Objective,associated,progression,atherosclerotic,vulnerable,plaques,However,patients,culprit,optical,coherence,tomography,OCT,defined,erosion,knowledge,microchannels,vulnerability,limited,aim,this,study,was,investigate,characteristics,segment,elevated,myocardial,infarction,STEMI,caused,by,without,using,Methods,who,underwent,2 ,Affiliated,Hospital,Harbin,Medical,University,China,from,August,December,were,included,divided,into,clinical,derived,features,compared,between,both,groups,Results,Among,lesions,had,higher,incidence,lipid,calcification,macrophages,accumulation,cholesterol,crystals,than,those,addition,minimal,lumen,area,smaller,2vs,mm ,stenosis,greater,Conclusion,one,third,manifested,typical,more,severe,luminal

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