Lesion Morphological Characteristics and Prognosis of Non-ST-Elevation Myocardial Infarction Patients With…

Abstract

BACKGROUND: Occlusion of the culprit artery (OCA) is observed in a substantial proportion of non-ST-segment elevation myocardial infarction (NSTEMI) patients, showing a poor clinical prognosis. NSTEMI management remains challenging, potentially due to pathophysiological mechanisms across different clinical phenotypes. This study investigated the morphological features of culprit plaque in NSTEMI with vs. without OCA. METHODS AND RESULTS: In all, 324 NSTEMI patients who underwent optical coherence tomography (OCT) imaging were enrolled in this study. Patients were divided into an OCA group (n=105; 32.4%) and a non-OCA group (n=219; 67.6%). Compared with the non-OCA group, the OCA group had significantly higher rates of plaque rupture (67.6% vs. 42.5%; P<0.001), lipid-rich plaque (81.0% vs. 67.1%; P=0.01), thin-cap fibroatheroma (48.6% vs. 25.1%; P<0.001), thrombus (88.6% vs. 66.7%; P<0.001), macrophage accumulation (92.4% vs. 76.7%; P<0.001), and cholesterol crystals (48.6% vs. 27.4%; P<0.001) on OCT. Symptom-to-catheter time was found to be an independent predictor of 2-year major adverse cardiovascular events for OCA patients. CONCLUSIONS: The underlying plaque morphologies were different between OCA and non-OCA patients. The OCA had a higher rate of plaque rupture, with more features (e.g., lipid-rich plaque, thin-cap fibroatheroma, thrombus, macrophage accumulation, cholesterol crystals) resembling ST-elevation myocardial infarction-like plaques. Symptom-to-catheter time was an independent predictor of major adverse cardiovascular events in the OCA group.

Evaluation of Clinical SYNTAX Score in Predicting New-Onset Atrial Fibrillation and Long-Term Prognosis in Patients Hospitalized with Non-ST Segment Elevation Myocardial Infarction
Zubeyir Bulat, Mehmet Emin Gokce, Sukru Arslan +7
Journal of cardiovascular development and disease29 Sep 2026Peer-reviewedCC BYFull textCardiovascular medicineEurope PMC
ST-Segment Elevation Myocardial Infarction Secondary to Aortic Root Thrombosis in a Patient With a Left Ventricular Assist Device
Umama Gorsi, Julia Kumar, Nathan Kim +2
Cureus16 Oct 2026Peer-reviewedCC BYFull textGeneral medicineEurope PMC
Anomalous left coronary artery origin unmasked by non-ST-elevation myocardial infarction
Miłosz Dziarmaga, Krzysztof Sobczyk, Mateusz Dziarmaga +2
Postepy w kardiologii interwencyjnej = Advances in interventional cardiology1 Sep 2026Peer-reviewedCC BY-NC-SAFull textGeneral medicineEurope PMCPMC
Outcome Stratification in Non-ST-Segment Elevation Myocardial Infarction: Standardized Assessment of Left Ventricular Global Longitudinal Strain
Yaoyuan Xiao, Xi Li, Qinghua Fu +2
Reviews in cardiovascular medicine1 Sep 2026Peer-reviewedCC BYFull textCardiovascular medicineEurope PMC
Simultaneous two-vessel occlusion causing ST-segment elevation myocardial infarction associated with elevated lipoprotein (a): A case report
Shingo Watanabe, Junichi Onuma, Ryota Ishida +2
Journal of Cardiology Cases16 Jul 2026Peer-reviewedLicence not statedFull textCardiovascular medicinePMC

Cite

BibTeX RIS

BibTeX

@article{shao2026lesion,
  title = {{Lesion Morphological Characteristics and Prognosis of Non-ST-Elevation Myocardial Infarction Patients With Different Types of Culprit Artery}},
  author = {Shuangtong Shao and Wentao Wang and Boling Yi and Minghao Liu and Chen Zhao and Ming Zeng and Huahui Ren and Qianhui Sun and Zhongrui Guo and Man Li and Sining Hu and Bo Yu and Gary S. Mintz and Haibo Jia},
  journal = {Circulation Journal},
  year = {2026},
  month = aug,
  doi = {10.1253/circj.cj-26-0096},
  url = {https://www.jstage.jst.go.jp/article/circj/advpub/0/advpub_CJ-26-0096/_article},
  note = {CC BY-NC-ND},
}

RIS

TY  - JOUR
TI  - Lesion Morphological Characteristics and Prognosis of Non-ST-Elevation Myocardial Infarction Patients With Different Types of Culprit Artery
AU  - Shuangtong Shao
AU  - Wentao Wang
AU  - Boling Yi
AU  - Minghao Liu
AU  - Chen Zhao
AU  - Ming Zeng
AU  - Huahui Ren
AU  - Qianhui Sun
AU  - Zhongrui Guo
AU  - Man Li
AU  - Sining Hu
AU  - Bo Yu
AU  - Gary S. Mintz
AU  - Haibo Jia
PY  - 2026
DA  - 2026/08/06
JO  - Circulation Journal
DO  - 10.1253/circj.cj-26-0096
UR  - https://www.jstage.jst.go.jp/article/circj/advpub/0/advpub_CJ-26-0096/_article
AB  - BACKGROUND: Occlusion of the culprit artery (OCA) is observed in a substantial proportion of non-ST-segment elevation myocardial infarction (NSTEMI) patients, showing a poor clinical prognosis. NSTEMI management remains challenging, potentially due to pathophysiological mechanisms across different clinical phenotypes. This study investigated the morphological features of culprit plaque in NSTEMI with vs. without OCA. METHODS AND RESULTS: In all, 324 NSTEMI patients who underwent optical coherence tomography (OCT) imaging were enrolled in this study. Patients were divided into an OCA group (n=105; 32.4%) and a non-OCA group (n=219; 67.6%). Compared with the non-OCA group, the OCA group had significantly higher rates of plaque rupture (67.6% vs. 42.5%; P<0.001), lipid-rich plaque (81.0% vs. 67.1%; P=0.01), thin-cap fibroatheroma (48.6% vs. 25.1%; P<0.001), thrombus (88.6% vs. 66.7%; P<0.001), macrophage accumulation (92.4% vs. 76.7%; P<0.001), and cholesterol crystals (48.6% vs. 27.4%; P<0.001) on OCT. Symptom-to-catheter time was found to be an independent predictor of 2-year major adverse cardiovascular events for OCA patients. CONCLUSIONS: The underlying plaque morphologies were different between OCA and non-OCA patients. The OCA had a higher rate of plaque rupture, with more features (e.g., lipid-rich plaque, thin-cap fibroatheroma, thrombus, macrophage accumulation, cholesterol crystals) resembling ST-elevation myocardial infarction-like plaques. Symptom-to-catheter time was an independent predictor of major adverse cardiovascular events in the OCA group.
SN  - 1347-4820
SN  - 1346-9843
ER  -

Abstract

Related

Cite