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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: 37767898Free PMC Article
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

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
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
Acute coronary syndrome and postprandial delayed hyperchylomicronemia.
Okajima F, Kurihara O, Takano M
Aging (Albany NY) 2019 May 14;11(9):2549-2550. doi: 10.18632/aging.101969. PMID: 31102505Free 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
Pathology of the unstable plaque.
Virmani R, Burke AP, Farb A, Kolodgie FD
Prog Cardiovasc Dis 2002 Mar-Apr;44(5):349-56. doi: 10.1053/pcad.2002.122475. PMID: 12024333

Diagnosis

Optical Coherence Tomography in Vulnerable Plaque and Acute Coronary Syndrome.
Kubo T
Interv Cardiol Clin 2023 Apr;12(2):203-214. Epub 2023 Jan 31 doi: 10.1016/j.iccl.2022.10.005. PMID: 36922061
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
Non-invasive and invasive imaging of vulnerable coronary plaque.
Celeng C, Takx RA, Ferencik M, Maurovich-Horvat P
Trends Cardiovasc Med 2016 Aug;26(6):538-47. Epub 2016 Mar 15 doi: 10.1016/j.tcm.2016.03.005. PMID: 27079893
Role of cardiac multidetector computed tomography beyond coronary angiography.
Sato A, Aonuma K
Circ J 2015;79(4):712-20. Epub 2015 Mar 5 doi: 10.1253/circj.CJ-15-0102. PMID: 25753692
Acute coronary syndrome: insight from angioscopy.
Ueda Y, Ogasawara N, Matsuo K, Hirotani S, Kashiwase K, Hirata A, Nishio M, Nemoto T, Wada M, Masumura Y, Kashiyama T, Konishi S, Nakanishi H, Kobayashi Y, Akazawa Y, Kodama K
Circ J 2010 Mar;74(3):411-7. Epub 2010 Jan 30 doi: 10.1253/circj.cj-09-0795. PMID: 20118566

Therapy

Preventive PCI or medical therapy alone for vulnerable atherosclerotic coronary plaque: Rationale and design of the randomized, controlled PREVENT trial.
Ahn JM, Kang DY, Lee PH, Ahn YK, Kim WJ, Nam CW, Jeong JO, Chae IH, Shiomi H, Kao PHL, Hahn JY, Her SH, Lee BK, Ahn TH, Chang K, Chae JK, Smyth D, Stone GW, Park DW, Park SJ; PREVENT Investigators
Am Heart J 2023 Oct;264:83-96. Epub 2023 Jun 2 doi: 10.1016/j.ahj.2023.05.017. PMID: 37271356
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
Thin-cap fibroatheroma predicts clinical events in diabetic patients with normal fractional flow reserve: the COMBINE OCT-FFR trial.
Kedhi E, Berta B, Roleder T, Hermanides RS, Fabris E, IJsselmuiden AJJ, Kauer F, Alfonso F, von Birgelen C, Escaned J, Camaro C, Kennedy MW, Pereira B, Magro M, Nef H, Reith S, Al Nooryani A, Rivero F, Malinowski K, De Luca G, Garcia Garcia H, Granada JF, Wojakowski W
Eur Heart J 2021 Dec 1;42(45):4671-4679. doi: 10.1093/eurheartj/ehab433. PMID: 34345911
Impact of TCFA on Unanticipated Ischemic Events in Medically Treated Diabetes Mellitus: Insights From the PROSPECT Study.
Kedhi E, Kennedy MW, Maehara A, Lansky AJ, McAndrew TC, Marso SP, De Bruyne B, Serruys PW, Stone GW
JACC Cardiovasc Imaging 2017 Apr;10(4):451-458. Epub 2016 Jun 29 doi: 10.1016/j.jcmg.2015.12.023. PMID: 27372016
Role of cardiac multidetector computed tomography beyond coronary angiography.
Sato A, Aonuma K
Circ J 2015;79(4):712-20. Epub 2015 Mar 5 doi: 10.1253/circj.CJ-15-0102. PMID: 25753692

Prognosis

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
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
Non-invasive and invasive imaging of vulnerable coronary plaque.
Celeng C, Takx RA, Ferencik M, Maurovich-Horvat P
Trends Cardiovasc Med 2016 Aug;26(6):538-47. Epub 2016 Mar 15 doi: 10.1016/j.tcm.2016.03.005. PMID: 27079893
Acute coronary syndrome: insight from angioscopy.
Ueda Y, Ogasawara N, Matsuo K, Hirotani S, Kashiwase K, Hirata A, Nishio M, Nemoto T, Wada M, Masumura Y, Kashiyama T, Konishi S, Nakanishi H, Kobayashi Y, Akazawa Y, Kodama K
Circ J 2010 Mar;74(3):411-7. Epub 2010 Jan 30 doi: 10.1253/circj.cj-09-0795. PMID: 20118566
Pathology of the unstable plaque.
Virmani R, Burke AP, Farb A, Kolodgie FD
Prog Cardiovasc Dis 2002 Mar-Apr;44(5):349-56. doi: 10.1053/pcad.2002.122475. PMID: 12024333

Clinical prediction guides

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
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
Non-invasive and invasive imaging of vulnerable coronary plaque.
Celeng C, Takx RA, Ferencik M, Maurovich-Horvat P
Trends Cardiovasc Med 2016 Aug;26(6):538-47. Epub 2016 Mar 15 doi: 10.1016/j.tcm.2016.03.005. PMID: 27079893
Acute coronary syndrome: insight from angioscopy.
Ueda Y, Ogasawara N, Matsuo K, Hirotani S, Kashiwase K, Hirata A, Nishio M, Nemoto T, Wada M, Masumura Y, Kashiyama T, Konishi S, Nakanishi H, Kobayashi Y, Akazawa Y, Kodama K
Circ J 2010 Mar;74(3):411-7. Epub 2010 Jan 30 doi: 10.1253/circj.cj-09-0795. PMID: 20118566
Pathology of the unstable plaque.
Virmani R, Burke AP, Farb A, Kolodgie FD
Prog Cardiovasc Dis 2002 Mar-Apr;44(5):349-56. doi: 10.1053/pcad.2002.122475. PMID: 12024333

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
Coronary Plaque Characteristics Associated With Major Adverse Cardiovascular Events in Atherosclerotic Patients and Lesions: A Systematic Review and Meta-Analysis.
Gallone G, Bellettini M, Gatti M, Tore D, Bruno F, Scudeler L, Cusenza V, Lanfranchi A, Angelini A, de Filippo O, Iannaccone M, Baldetti L, Audisio K, Demetres M, Risi G, Rizzello G, Porto I, Fonio P, Prati F, Williams MC, Koo BK, Pontone G, Depaoli A, Libby P, Stone GW, Narula J, de Ferrari GM, d'Ascenzo F
JACC Cardiovasc Imaging 2023 Dec;16(12):1584-1604. Epub 2023 Oct 4 doi: 10.1016/j.jcmg.2023.08.006. PMID: 37804276
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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