Qin Zhifeng, Yu Li, Zhang Yanwen, Xu Qinglu, Li Chao, Zhao Suhong, Xi Xiangwen, Tian Yanan, Wang Zhao, Tian Jinwei, Yu Bo
Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
The Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin, China.
Heliyon. 2023 Dec 3;9(12):e23191. doi: 10.1016/j.heliyon.2023.e23191. eCollection 2023 Dec.
Coronary artery calcification (CAC), a surrogate of atherosclerosis, is related to stent underexpansion and adverse cardiac events. However, the effect of CAC on plaque stability is still controversial and the morphological significance of CAC has yet to be elucidated.
A retrospective series of 419 patients with acute coronary syndrome (ACS) who underwent optical coherence tomography (OCT) were enrolled. Patients were classified into three groups based on the calcification size in culprit plaques and the features of the culprit and non-culprit plaques among these groups were compared. Logistic regression was used to analyze independent risk factors for culprit plaque rupture and the nonlinear relationship between calcification parameters and culprit plaque rupture. Furthermore, we compared the detailed calcification parameters of different kinds of plaques.
A total of 419 culprit plaques and 364 non-culprit plaques were identified. The incidence of calcification was 53.9 % in culprit plaques and 50.3 % in non-culprit plaques. Compared with culprit plaques without calcification, plaque rupture, macrophages and cholesterol crystals were more frequently observed in the spotty calcification group, and the lipid length was longer; the incidence of macrophages and cholesterol crystals was higher in the macrocalcification group. Calcification tended to be smaller in ruptured plaques than in non-ruptured plaques. Moreover, the arc and length of calcification were greater in culprit plaques than in non-culprit plaques.
Vulnerable features were more frequently observed in culprit plaques with spotty calcification, whereas the presence of macrocalcification calcifications did not significantly increase plaque vulnerability. Calcification tends to be larger in culprit plaques than in non-culprit plaques.
冠状动脉钙化（CAC）是动脉粥样硬化的一个替代指标，与支架扩张不全及不良心脏事件相关。然而，CAC对斑块稳定性的影响仍存在争议，其形态学意义也有待阐明。
纳入419例行光学相干断层扫描（OCT）的急性冠状动脉综合征（ACS）患者的回顾性系列研究。根据罪犯斑块中的钙化大小将患者分为三组，并比较这些组中罪犯斑块和非罪犯斑块的特征。采用逻辑回归分析罪犯斑块破裂的独立危险因素以及钙化参数与罪犯斑块破裂之间的非线性关系。此外，我们比较了不同类型斑块的详细钙化参数。
共识别出419个罪犯斑块和364个非罪犯斑块。罪犯斑块中钙化的发生率为53.9%，非罪犯斑块中为50.3%。与无钙化的罪犯斑块相比，斑点状钙化组更常观察到斑块破裂、巨噬细胞和胆固醇结晶，且脂质长度更长；大钙化组中巨噬细胞和胆固醇结晶的发生率更高。破裂斑块中的钙化往往比未破裂斑块中的小。此外，罪犯斑块中钙化的弧度和长度大于非罪犯斑块。
在有斑点状钙化的罪犯斑块中更常观察到易损特征，而大钙化的存在并未显著增加斑块易损性。罪犯斑块中的钙化往往比非罪犯斑块中的大。
