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Thin-cap fibroatheroma

MedGen UID:
1393553
•Concept ID:
C4476910
•
Acquired Abnormality
Synonym: TCFA
 
HPO: HP:0031012

Definition

Thin-cap fibroatheroma is characterized by a relatively large necrotic core with an overlying thin fibrous cap measuring less than 65 micrometers and typically containing numerous macrophages, and is considered to be the precursor lesion of plaque rupture which is the most common cause of coronary thrombosis. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVThin-cap fibroatheroma

Professional guidelines

PubMed

The plaque hypothesis: understanding mechanisms of plaque progression and destabilization, and implications for clinical management.
Ahmed ME, Hakim D, Stone PH
Curr Opin Cardiol 2023 Nov 1;38(6):496-503. Epub 2023 Aug 28 doi: 10.1097/HCO.0000000000001077. PMID: 37767898
Exploring new insights in coronary lesion assessment and treatment in patients with diabetes mellitus: the impact of optical coherence tomography.
Hommels TM, Hermanides RS, Fabris E, Kedhi E
Cardiovasc Diabetol 2023 May 24;22(1):123. doi: 10.1186/s12933-023-01844-1. PMID: 37226183Free PMC Article
Clinical utility and significance of intravascular ultrasound and optical coherence tomography in guiding percutaneous coronary interventions.
Hibi K, Kimura K, Umemura S
Circ J 2015;79(1):24-33. Epub 2014 Dec 19 doi: 10.1253/circj.CJ-14-1044. PMID: 25744628

Recent clinical studies

Etiology

Identification of High-Risk Coronary Lesions by 3-Vessel Optical Coherence Tomography.
Jiang S, Fang C, Xu X, Xing L, Sun S, Peng C, Yin Y, Lei F, Wang Y, Li L, Chen Y, Pei X, Jia R, Tang C, Li S, Li S, Yu H, Chen T, Tan J, Liu X, Hou J, Dai J, Yu B
J Am Coll Cardiol 2023 Apr 4;81(13):1217-1230. Epub 2023 Mar 14 doi: 10.1016/j.jacc.2023.01.030. PMID: 36925409
Vulnerable plaques and patients: state-of-the-art.
Tomaniak M, Katagiri Y, Modolo R, de Silva R, Khamis RY, Bourantas CV, Torii R, Wentzel JJ, Gijsen FJH, van Soest G, Stone PH, West NEJ, Maehara A, Lerman A, van der Steen AFW, Lüscher TF, Virmani R, Koenig W, Stone GW, Muller JE, Wijns W, Serruys PW, Onuma Y
Eur Heart J 2020 Aug 14;41(31):2997-3004. doi: 10.1093/eurheartj/ehaa227. PMID: 32402086Free PMC Article
Postprandial Hyperchylomicronemia and Thin-Cap Fibroatheroma in Nonculprit Lesions.
Kurihara O, Okajima F, Takano M, Kato K, Munakata R, Murakami D, Miyauchi Y, Emoto N, Sugihara H, Seino Y, Shimizu W
Arterioscler Thromb Vasc Biol 2018 Aug;38(8):1940-1947. doi: 10.1161/ATVBAHA.118.311245. PMID: 29930008
Coronary Artery Calcification: From Mechanism to Molecular Imaging.
Nakahara T, Dweck MR, Narula N, Pisapia D, Narula J, Strauss HW
JACC Cardiovasc Imaging 2017 May;10(5):582-593. doi: 10.1016/j.jcmg.2017.03.005. PMID: 28473100
Thin-cap fibroatheroma rupture is associated with a fine interplay of shear and wall stress.
Pedrigi RM, de Silva R, Bovens SM, Mehta VV, Petretto E, Krams R
Arterioscler Thromb Vasc Biol 2014 Oct;34(10):2224-31. Epub 2014 Jul 24 doi: 10.1161/ATVBAHA.114.303426. PMID: 25060797

Diagnosis

Identification of High-Risk Coronary Lesions by 3-Vessel Optical Coherence Tomography.
Jiang S, Fang C, Xu X, Xing L, Sun S, Peng C, Yin Y, Lei F, Wang Y, Li L, Chen Y, Pei X, Jia R, Tang C, Li S, Li S, Yu H, Chen T, Tan J, Liu X, Hou J, Dai J, Yu B
J Am Coll Cardiol 2023 Apr 4;81(13):1217-1230. Epub 2023 Mar 14 doi: 10.1016/j.jacc.2023.01.030. PMID: 36925409
Vulnerable plaques and patients: state-of-the-art.
Tomaniak M, Katagiri Y, Modolo R, de Silva R, Khamis RY, Bourantas CV, Torii R, Wentzel JJ, Gijsen FJH, van Soest G, Stone PH, West NEJ, Maehara A, Lerman A, van der Steen AFW, Lüscher TF, Virmani R, Koenig W, Stone GW, Muller JE, Wijns W, Serruys PW, Onuma Y
Eur Heart J 2020 Aug 14;41(31):2997-3004. doi: 10.1093/eurheartj/ehaa227. PMID: 32402086Free PMC Article
Prediction of coronary thin-cap fibroatheroma by intravascular ultrasound-based machine learning.
Bae Y, Kang SJ, Kim G, Lee JG, Min HS, Cho H, Kang DY, Lee PH, Ahn JM, Park DW, Lee SW, Kim YH, Lee CW, Park SW, Park SJ
Atherosclerosis 2019 Sep;288:168-174. Epub 2019 May 4 doi: 10.1016/j.atherosclerosis.2019.04.228. PMID: 31130215
Postprandial Hyperchylomicronemia and Thin-Cap Fibroatheroma in Nonculprit Lesions.
Kurihara O, Okajima F, Takano M, Kato K, Munakata R, Murakami D, Miyauchi Y, Emoto N, Sugihara H, Seino Y, Shimizu W
Arterioscler Thromb Vasc Biol 2018 Aug;38(8):1940-1947. doi: 10.1161/ATVBAHA.118.311245. PMID: 29930008
Coronary Artery Calcification: From Mechanism to Molecular Imaging.
Nakahara T, Dweck MR, Narula N, Pisapia D, Narula J, Strauss HW
JACC Cardiovasc Imaging 2017 May;10(5):582-593. doi: 10.1016/j.jcmg.2017.03.005. PMID: 28473100

Therapy

Identification of High-Risk Coronary Lesions by 3-Vessel Optical Coherence Tomography.
Jiang S, Fang C, Xu X, Xing L, Sun S, Peng C, Yin Y, Lei F, Wang Y, Li L, Chen Y, Pei X, Jia R, Tang C, Li S, Li S, Yu H, Chen T, Tan J, Liu X, Hou J, Dai J, Yu B
J Am Coll Cardiol 2023 Apr 4;81(13):1217-1230. Epub 2023 Mar 14 doi: 10.1016/j.jacc.2023.01.030. PMID: 36925409
Biomarkers associated with coronary high-risk plaques.
Nakajima A, Libby P, Mitomo S, Yuki H, Araki M, Seegers LM, McNulty I, Lee H, Ishibashi M, Kobayashi K, Dijkstra J, Ouchi T, Onishi H, Yabushita H, Matsuoka S, Kawamoto H, Watanabe Y, Tanaka K, Chou S, Sato T, Naganuma T, Okutsu M, Tahara S, Kurita N, Nakamura S, Kuter DJ, Nakamura S, Jang IK
J Thromb Thrombolysis 2022 Nov;54(4):647-659. Epub 2022 Oct 7 doi: 10.1007/s11239-022-02709-2. PMID: 36205839
Pitavastatin: Coronary Atherosclerotic Plaques Changes and Cardiovascular Prevention.
Fici F, Faikoglu G, Tarim BA, Robles NR, Tsioufis K, Grassi G, Gungor B
High Blood Press Cardiovasc Prev 2022 Mar;29(2):137-144. Epub 2022 Jan 22 doi: 10.1007/s40292-021-00496-0. PMID: 35064911
Prediction of coronary thin-cap fibroatheroma by intravascular ultrasound-based machine learning.
Bae Y, Kang SJ, Kim G, Lee JG, Min HS, Cho H, Kang DY, Lee PH, Ahn JM, Park DW, Lee SW, Kim YH, Lee CW, Park SW, Park SJ
Atherosclerosis 2019 Sep;288:168-174. Epub 2019 May 4 doi: 10.1016/j.atherosclerosis.2019.04.228. PMID: 31130215
Stabilizing effect of combined eicosapentaenoic acid and statin therapy on coronary thin-cap fibroatheroma.
Nishio R, Shinke T, Otake H, Nakagawa M, Nagoshi R, Inoue T, Kozuki A, Hariki H, Osue T, Taniguchi Y, Iwasaki M, Hiranuma N, Konishi A, Kinutani H, Shite J, Hirata K
Atherosclerosis 2014 May;234(1):114-9. Epub 2014 Mar 5 doi: 10.1016/j.atherosclerosis.2014.02.025. PMID: 24637411

Prognosis

Identification of High-Risk Coronary Lesions by 3-Vessel Optical Coherence Tomography.
Jiang S, Fang C, Xu X, Xing L, Sun S, Peng C, Yin Y, Lei F, Wang Y, Li L, Chen Y, Pei X, Jia R, Tang C, Li S, Li S, Yu H, Chen T, Tan J, Liu X, Hou J, Dai J, Yu B
J Am Coll Cardiol 2023 Apr 4;81(13):1217-1230. Epub 2023 Mar 14 doi: 10.1016/j.jacc.2023.01.030. PMID: 36925409
Vulnerable plaques and patients: state-of-the-art.
Tomaniak M, Katagiri Y, Modolo R, de Silva R, Khamis RY, Bourantas CV, Torii R, Wentzel JJ, Gijsen FJH, van Soest G, Stone PH, West NEJ, Maehara A, Lerman A, van der Steen AFW, Lüscher TF, Virmani R, Koenig W, Stone GW, Muller JE, Wijns W, Serruys PW, Onuma Y
Eur Heart J 2020 Aug 14;41(31):2997-3004. doi: 10.1093/eurheartj/ehaa227. PMID: 32402086Free PMC Article
Coronary Artery Calcification: From Mechanism to Molecular Imaging.
Nakahara T, Dweck MR, Narula N, Pisapia D, Narula J, Strauss HW
JACC Cardiovasc Imaging 2017 May;10(5):582-593. doi: 10.1016/j.jcmg.2017.03.005. PMID: 28473100
Thin-cap fibroatheroma rupture is associated with a fine interplay of shear and wall stress.
Pedrigi RM, de Silva R, Bovens SM, Mehta VV, Petretto E, Krams R
Arterioscler Thromb Vasc Biol 2014 Oct;34(10):2224-31. Epub 2014 Jul 24 doi: 10.1161/ATVBAHA.114.303426. PMID: 25060797
Pathology of the thin-cap fibroatheroma: a type of vulnerable plaque.
Virmani R, Burke AP, Kolodgie FD, Farb A
J Interv Cardiol 2003 Jun;16(3):267-72. doi: 10.1034/j.1600-0854.2003.8042.x. PMID: 12800406

Clinical prediction guides

Identification of High-Risk Coronary Lesions by 3-Vessel Optical Coherence Tomography.
Jiang S, Fang C, Xu X, Xing L, Sun S, Peng C, Yin Y, Lei F, Wang Y, Li L, Chen Y, Pei X, Jia R, Tang C, Li S, Li S, Yu H, Chen T, Tan J, Liu X, Hou J, Dai J, Yu B
J Am Coll Cardiol 2023 Apr 4;81(13):1217-1230. Epub 2023 Mar 14 doi: 10.1016/j.jacc.2023.01.030. PMID: 36925409
Vulnerable plaques and patients: state-of-the-art.
Tomaniak M, Katagiri Y, Modolo R, de Silva R, Khamis RY, Bourantas CV, Torii R, Wentzel JJ, Gijsen FJH, van Soest G, Stone PH, West NEJ, Maehara A, Lerman A, van der Steen AFW, Lüscher TF, Virmani R, Koenig W, Stone GW, Muller JE, Wijns W, Serruys PW, Onuma Y
Eur Heart J 2020 Aug 14;41(31):2997-3004. doi: 10.1093/eurheartj/ehaa227. PMID: 32402086Free PMC Article
Prediction of coronary thin-cap fibroatheroma by intravascular ultrasound-based machine learning.
Bae Y, Kang SJ, Kim G, Lee JG, Min HS, Cho H, Kang DY, Lee PH, Ahn JM, Park DW, Lee SW, Kim YH, Lee CW, Park SW, Park SJ
Atherosclerosis 2019 Sep;288:168-174. Epub 2019 May 4 doi: 10.1016/j.atherosclerosis.2019.04.228. PMID: 31130215
Coronary Artery Calcification: From Mechanism to Molecular Imaging.
Nakahara T, Dweck MR, Narula N, Pisapia D, Narula J, Strauss HW
JACC Cardiovasc Imaging 2017 May;10(5):582-593. doi: 10.1016/j.jcmg.2017.03.005. PMID: 28473100
Thin-cap fibroatheroma rupture is associated with a fine interplay of shear and wall stress.
Pedrigi RM, de Silva R, Bovens SM, Mehta VV, Petretto E, Krams R
Arterioscler Thromb Vasc Biol 2014 Oct;34(10):2224-31. Epub 2014 Jul 24 doi: 10.1161/ATVBAHA.114.303426. PMID: 25060797

Recent systematic reviews

Prognostic impact of monocyte-to-lymphocyte ratio in coronary heart disease: a systematic review and meta-analysis.
Vakhshoori M, Nemati S, Sabouhi S, Shakarami M, Yavari B, Emami SA, Bondariyan N, Shafie D
J Int Med Res 2023 Oct;51(10):3000605231204469. doi: 10.1177/03000605231204469. PMID: 37848392Free PMC Article
Automated Coronary Optical Coherence Tomography Feature Extraction with Application to Three-Dimensional Reconstruction.
Carpenter HJ, Ghayesh MH, Zander AC, Li J, Di Giovanni G, Psaltis PJ
Tomography 2022 May 17;8(3):1307-1349. doi: 10.3390/tomography8030108. PMID: 35645394Free PMC Article
Intravascular ultrasound insights into the unstable features of the coronary atherosclerotic plaques: A systematic review and meta-analysis.
Homorodean C, Leucuta DC, Ober M, Homorodean R, Spinu M, Olinic M, Tataru D, Olinic DM
Eur J Clin Invest 2022 Jan;52(1):e13671. Epub 2021 Aug 30 doi: 10.1111/eci.13671. PMID: 34411283
Plaque composition by intravascular ultrasound and distal embolization after percutaneous coronary intervention.
Claessen BE, Maehara A, Fahy M, Xu K, Stone GW, Mintz GS
JACC Cardiovasc Imaging 2012 Mar;5(3 Suppl):S111-8. doi: 10.1016/j.jcmg.2011.11.018. PMID: 22421225

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