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. 2021 Nov 22:8:761208.
doi: 10.3389/fcvm.2021.761208. eCollection 2021.

Prevalence of Healed Plaque and Factors Influencing Its Characteristics Under Optical Coherence Tomography in Patients With Coronary Artery Disease: A Systematic Review, Meta-Analysis, and Meta-Regression

Xunxun Feng  1 , Yang Liu  1 , Jiaqi Yang  1 , Guangyao Zhai  1 , Yujie Zhou  1 , Qianyun Guo  1
Affiliations

Prevalence of Healed Plaque and Factors Influencing Its Characteristics Under Optical Coherence Tomography in Patients With Coronary Artery Disease: A Systematic Review, Meta-Analysis, and Meta-Regression

Xunxun Feng et al. Front Cardiovasc Med. .

Abstract

Aim: The purpose of this study was to determine the prevalence of healed plaque and its characteristics under optical coherence tomography (OCT) through a formal systematic review, meta-analysis, and meta-regression. Methods and Results: Thirteen studies were selected from MEDLINE, EMBASE, Cochrane, and online databases. The overall incidence of healed plaques was 40% (95% CI: 39-42), with 37% (95% CI: 35-39) in patients with acute coronary syndrome (ACS) and with 46% (95% CI: 43-49) in patients with stable angina pectoris (SAP). The incidence of healed plaque among culprit plaques (48%, 95% CI: 46-50) was nearly two times higher than that among non-culprit plaques (24%, 95% CI: 21-27). The incidence of thin cap fibroatheroma (TCFA), plaque rupture, microvessel, macrophage accumulation, and calcification was significantly higher in the healed plaque group. Meta-regression revealed an association between smoking (P = 0.033) and healed plaque rupture. Gender (P = 0.047) was independently associated with macrophage accumulation, and mean low-density lipoprotein cholesterol (LDL-C) was independently associated with microvessel. Conclusions: In summary, with a total incidence of 40%, the incidence of healed plaques under OCT was higher in SAP than in ACS, and higher in culprit plaques than in non-culprit plaques. Higher incidence of TCFA, plaque rupture, microvessel, macrophage accumulation, and calcification was found in the healed-plaque group. Smoking, gender, and mean LDL-C level were associated with healed-plaque characteristics.

Keywords: characteristics; coronary artery disease; healed plaque; meta-analysis; meta-regression; optical coherence tomography; prevalence; systematic review.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The prevalence of healed plaque in different population. OCT, optical coherence tomography; ACS, acute coronary syndrome; SAP, stable angina pectoris.
Figure 2
Figure 2
Summary of qualitative characteristics of healed plaques in the total population. TCFA, thin-cap fibroatheroma.
Figure 3
Figure 3
Summary of quantitative characteristics of healed plaques in the total population. MLA, minimal lumen area; RLA, reference lumen area; AS, area stenosis.
Figure 4
Figure 4
Meta-regression for smoking as an influence factor of plaque rupture in overall population.
Figure 5
Figure 5
Meta-regression for gender as an influence factor of macrophage accumulation in overall population.
Figure 6
Figure 6
Funnel plot for characteristics of healed plaque. TCFA, thin-cap fibroatheroma; MLA, minimal lumen area; RLA, reference lumen area; AS, area stenosis.
See this image and copyright information in PMC

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