Coronary disease & ACSMeta-analysis
Silent plaque ruptures in non-obstructive lesions of non–infarct-related arteries: a multimodality, serial intracoronary imaging study
- Pooled analysis of the IBIS-4 and PACMAN-AMI trials (serial intracoronary imaging study)
- multimodality intracoronary imaging
- serial imaging at baseline and 52 weeks
Authors' conclusion
Plaque rupture in non-obstructive lesions of non-IRAs was present in 12% of AMI patients. Larger plaque volume, positive remodeling, and thinner fibrous cap were associated with rupture. More than half of untreated ruptures transitioned into stable morphologies. Thin-cap fibroatheroma was the most frequent underlying morphology of new-onset rupture.
Study context
- Population
- Patients with acute MI, non-obstructive lesions of non-infarct-related arteries
- Participants
- 336 patients · 783 lesions
- Comparison
- Non-IRA lesions with vs without plaque rupture
- Rupturen = 41
- Outcome
- Frequency and lesion characteristics of plaque rupture in non-IRAs
- Follow-up
- Baseline
Pooled result
As reported in the abstract
Plaque rupture frequency and lesion characteristics
Rupture
12%
41 of 41
No rupture
49.5 ± 5.8%
Percent atheroma volume · External elastic membrane area 15.7 ± 5.6 mm² · Minimum fibrous cap thickness 116 ± 84 μm
Rupture vs No ruptureEstimated difference, % (CI)
percent atheroma volume
3.6(1.9–5.4)
Rupture vs No ruptureEstimated difference, mm2 (CI)
external elastic membrane area
4.1(2.5–5.7)
Rupture vs No ruptureEstimated difference, μm (CI)
minimum fibrous cap thickness
−43(−75 to −11)
Further pooled results
- Healing of rupture sites (serial) · 52 weeks
- 51% · 21 of 41
- Healing of rupture sites (serial): 41 rupture sites assessed serially
New-onset rupture · 52 weeks
- Newly identified rupture sites; thin-cap fibroatheroma most frequent baseline morphology
- 10
Original publication
Silent plaque ruptures in non-obstructive lesions of non–infarct-related arteries: a multimodality, serial intracoronary imaging study. Eur Heart J. Published 9 March 2026. doi:10.1093/eurheartj/ehag037
Summarised from the published abstract; every number is checked against it