Identification of Predictors for Coronary Plaque Erosion in Patients With Acute Coronary Syndrome

Plaque erosion is reported to be responsible for about one third of patients with acute
coronary syndrome (ACS). In the EROSION study, we reported that antithrombotic therapy
without stenting achieved a reduction in thrombus volume greater than 50% in over 70% of
patients diagnosed with ACS caused by plaque erosion. This result suggests that the
conservative approach of anti-thrombotic therapy without stenting may be an option for
patients diagnosed with ACS caused by plaque erosion, which may be the paradigm shift in
treatment of ACS patients. However, at present, the only way to make an in vivo diagnosis of
plaque erosion is intra-coronary optical coherence tomography (OCT). If we can identify
clinical factors associated with plaque erosion, we may be able to narrow down a
sub-population of patients with a higher likelihood of plaque erosion. This group of patients
may be stabilized with pharmacologic therapy and avoid invasive procedures, thereby
preventing related complications and reducing health care burden. However, specific
demographic characteristics of the ACS patients with plaque erosion are not known. Our group
has the world's largest dataset of patients with plaque erosion and several published reports
on plaque erosion. However, the study population of each study is still small and unbalanced
to identify the demographic characteristics associated with plaque erosion. Therefore, we
propose to pool data from a large number of institutions around the world. This will provide
an opportunity to identify factors associated with plaque erosion.

Inclusion Criteria:

1. Diagnosed with ACS upon admission to hospital, including patients with ST-elevation
myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), and
unstable angina pectoris (UAP).

2. Intra-vascular OCT imaging of culprit vessel.

Exclusion Criteria: